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Top 5 Services Original Medicare Does Not Cover


Original Medicare provides beneficiaries with great health benefits. However, beyond basic health care needs, there are several services not covered by Original Medicare. Below, we review a list of the top 5 services not covered by Original Medicare that many seniors struggle with every day.

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#1 Foreign Travel Health Coverage

First on our list of top 5 services not covered by Original Medicare is foreign travel health care coverage. Dreams of world travel are at the forefront of many people’s minds when reaching retirement age.

However, it is necessary to be sure you have coverage in case of an emergency abroad. Unfortunately, Original Medicare does not cover any health care services when traveling outside of the U.S.

To fill this hole in Original Medicare coverage, most Medicare Supplement plans offer foreign travel emergency coverage. This helps cover medical costs in the case of an emergency while abroad. These plans offer 80% coverage up to $50,000 for foreign travel benefits after you meet the foreign travel deductible.

#2 Prescription Drug Coverage

Number two on our list of the top 5 service not covered by Original Medicare is prescription drug coverage. Original Medicare consists of Medicare Part A and Medicare Part B which cover hospital and doctor services, respectively. However, neither part includes coverage for prescription medications.

To receive help covering the cost of prescription drugs, beneficiaries can enroll in Medicare Part D. Medicare Part D plans cover Original Medicare’s gap in prescription drug coverage. You can enroll in Medicare Part D when you first enroll in Medicare or during the Annual Enrollment Period.

Medicare is not mandatory. However, if you delay enrollment in Medicare Part D, you could receive a penalty if you do not have creditable coverage.

#3 Routine Vision Coverage

Coming in at number three on our list of top 5 services not covered by Original Medicare is routine vision care. Routine vision care is a necessity many Medicare beneficiaries go without. As we age, our eyesight is known to deteriorate. Thus, finding alternate forms of coverage is essential for Medicare beneficiaries.

In a 2020 research study, cbpp.org reported only around 19% of all Medicare beneficiaries have vision coverage. This means almost 80% of Medicare beneficiaries pay 100% of their vision costs out-of-pocket.

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Many Medicare beneficiaries receive their vision coverage from a Medicare Advantage plan or a stand-alone vision plan. Both options can help cover the cost of basic exams, eyeglasses, contacts, and more. Your vision needs will be the determining factor in which plan is best for you.

#4 Routine Dental Coverage

Number four on the list of top 5 services Original Medicare does not cover is routine dental care. If you need coverage for annual dental exams or cleanings, Original Medicare alone will not be of service to you. For aging Baby Boomers, dental care is an important element for preventing many major health concerns. However, many seniors on Medicare do not have additional dental coverage.

Because Medicare does not cover dental services, beneficiaries are often left covering these expenses out-of-pocket. According to cnbc.com, nearly 37 million people on Medicare do not have dental coverage. That is just over half of all seniors 65 and up.

Dental insurance options for seniors choose one of two options. You can either enroll in a stand-alone dental plan or in a Medicare Advantage plan that offers dental coverage. However, if you enroll in the latter, it is important to understand your Medicare Advantage plan’s health care coverage as well.

If you prefer to enroll in a Medicare Supplement plan, stand-alone dental plans are popular among beneficiaries. These plans offer dental coverage for care ranging from preventive to major services like oral surgery or dental implants at a low monthly premium.

#5 Long-Term Care Coverage

Completing the list of top 5 services Original Medicare does not cover is long-term care. Long-term care can potentially become one of your largest, unexpected expenses after retirement that Original Medicare does not cover. Original Medicare will cover a set number of days in a skilled nursing facility. However, it does not cover custodial care such as dressing, bathing, toileting, and other necessary activities of daily living.

According to genworth.com, 7 of 10 people over the age of 65 will eventually require care in a long-term care facility. In 2021, the average cost of long-term care was nearly $10,000 for a private room.

To receive coverage for long-term care, it is essential to enroll in a long-term care policy to help cover these expenses. However, the younger you are when you enroll, the more cost-effective the monthly premium will be. The longer you wait, the more expensive the policy becomes. Also, these policies require underwriting health questions. So, it is best to enroll while you are healthy.

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How to Find Additional Coverage for Medicare

If you are looking for additional coverage for benefits not covered by Original Medicare, our agents are here to help! We review all plans in your area to ensure you have the best coverage possible.

We understand the importance of insurance coverage, so we want to be sure you are enrolled in the best plans, the first time. Call the number above or complete our online rate form to get started today.

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Sources:

MedicareFAQ is dedicated to providing you with authentic and trustworthy Medicare information. We have strict sourcing guidelines and work diligently to serve our readers with accurate and up-to-date content.

  1. With Half of Adults Over 65 Lacking Dental Insurance, Poll Finds Strong Support for Universal Medicare Dental Benefit, University of Michigan. Accessed March 2022.
    https://labblog.uofmhealth.org/industry-dx/half-of-adults-over-65-lacking-dental-insurance-poll-finds-strong-support-for-universal/
  2. Long Term Care, Medicare. Accessed March 2022.
    https://www.medicare.gov/coverage/long-term-care
  3. Routine Eye Exams, Medicare. Accessed March 2022.
    https://www.medicare.gov/coverage/eye-exams-routine
  4. Medicare Coverage Outside United States, Medicare. Accessed March 2022.
    https://www.medicare.gov/Pubs/pdf/11037-Medicare-Coverage-Outside-United-States.pdf

Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

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