En español | Medicare Part B covers a very wide range of medical care — from routine services like flu shots and X-rays to big-ticket items such as organ transplants, delicate surgery to repair serious injuries, expensive cancer treatments and many others. It also covers a variety of preventive measures (such as tests and screenings), often at no cost to you. But there are still some services that Part B does not pay for.
If you’re enrolled in the original Medicare program, these gaps in coverage include:
- Routine services for vision, hearing and dental care — for example, checkups, eyeglasses, hearing aids, dental extractions and dentures. (However, Medicare covers medically necessary care, such as cataract surgery or jaw reconstruction after a serious injury.)
- Routine services for foot care, such as toenail clipping or the removal of corns and calluses — unless you have foot problems caused by conditions such as diabetes, cancer, multiple sclerosis, chronic kidney disease, malnutrition or inflammation of the veins related to blood clots. (Medicare coverage is provided only if your doctor or podiatrist provides evidence that foot care is medically necessary.)
- Home safety items, such as grab bars in the bathroom, stair lifts or elevators, bathtub lifts or seats, medical emergency alert systems, etc. (Medicare coverage is a available for a few items it deems medically reasonable if a doctor prescribes them — for example, seat lifts to help you get out of a chair or trapeze bars to help you sit up when confined to bed.)
- Long-term care in nursing homes or assisted living facilities. In these situations, Medicare covers your medical needs but does not cover any custodial care, meaning help with daily activities such as dressing, feeding, bathing, going to the bathroom, etc. (Medicare covers short-term care in skilled nursing facilities, which may be nursing homes, when you qualify for continued nursing care and rehab work.)
- Medical services outside of the United States and its territories, except in rare circumstances.
- Any care that Medicare does not consider medically necessary, such as cosmetic surgery and fitness programs, or regards as alternative medicine, such as acupuncture.
Note: Medicare Advantage plans, such as HMOs or PPOs, must cover all the same Part B services that the original Medicare program does. But they may also offer extra benefits that cover some of the gaps listed above. Some plans, for example, provide coverage for routine hearing, vision and/or dental care, fitness programs and gym memberships, and emergency care abroad. Check with your plan.