AARP Hearing Center
Key takeaways
- Discover six Medicare coverage gaps that often surprise older adults.
- Understand when original Medicare provides limited exceptions for certain services.
- Plan ahead for dental, hearing and long-term care expenses.
- Compare Medicare options that may include additional routine health care benefits.
Summary
Original Medicare coverage includes important health care benefits, but it does not cover several services that many people assume are included. Vision care, replacement glasses, hearing aids, routine hearing exams, routine chiropractic adjustments, massage therapy, most dental care and long-term care are among the notable gaps discussed in this video. Certain exceptions apply, such as glasses after cataract surgery, annual eye exams for people with diabetes and limited rehabilitation stays following specific medical events.
Understanding these Medicare coverage limitations can help people better prepare for health care expenses and evaluate coverage options. The discussion also highlights that some Medicare Advantage plans may offer additional benefits such as routine eye, hearing and dental services, though significant out-of-pocket costs may still apply for some needs.
The key takeaways and summary were created with the assistance of generative AI. An AARP editor reviewed and refined the content for accuracy and clarity.
Full transcript
[0:00:00] When it comes to original Medicare, most people assume it covers all the basics — things like vision, hearing and dental. But the reality? Some of those things aren’t covered at all, and a few are covered only in very specific situations.
[0:00:15] Let’s take a closer look at a few common examples that tend to catch people off-guard.
[0:00:20] Say you lose or break your prescription glasses. We’ve all been there, right? But will original Medicare cover a new pair? Unfortunately, original Medicare
[0:00:30] will not replace your glasses. But it will pay for your first pair of glasses if you ever need cataract surgery. And what about eye checkups? Routine eye care is also not covered.
[0:00:41] But if you have diabetes, Medicare pays for one
[0:00:45] eye exam per year. Now let’s say Mom or Dad is having a hard time hearing you. They could be just tuning you out, or it may be time for a hearing aid. Unfortunately, hearing aids and related hearing exams also
[0:01:00] fall under not covered. OK. Now what if you get regular chiropractic adjustments as part of your wellness plan?
[0:01:07] Original Medicare does not cover routine chiropractic adjustments. But say you throw your back out
[0:01:15] moving a heavy piece of furniture. The good news is Medicare will cover chiropractic care, with limits, for pain management, physical therapy or occupational therapy with a doctor’s prescription. And speaking of
[0:01:30] wellness, is there anything better than a nice massage?
[0:01:33] Well, when it comes to massage, that’s also off the table. Pun intended. Original Medicare won’t cover it, even for chronic pain. Now say you’re at the dentist,
[0:01:45] and you hear those dreaded two words: root canal. Unfortunately, original Medicare does not cover root canals. Nor does it cover cleanings, fillings, extractions or dentures.
[0:01:58] So you may wanna look into private
[0:02:00] dental coverage to maintain those pearly whites. And finally, let’s look at long-term care. This is a big one. Original Medicare does not pay for most ongoing care in nursing homes or assisted living. So
[0:02:15] it’s important to plan ahead, because this is a major gap in coverage.
[0:02:19] But if you or a loved one breaks a bone or needs a hip replacement, then original Medicare will pay for limited stays in rehab for recovery.
[0:02:30] OK, let’s wrap this up. Even though original Medicare doesn’t pay for a lot of things, many, but not all, Medicare Advantage plans do cover things like basic teeth cleaning and routine eye and hearing exams.
[0:02:45] You’ll still find yourself paying out of pocket for the big items that many older adults need. So be sure to check out those options during the next enrollment period. And since I mentioned Medicare Advantage, you might like my breakdown between
[0:03:00] original versus Advantage options in the video below. If you have a Medicare coverage question that we didn’t include in this video, you can find more information by visiting aarp.org/medicare
