One of the most common Medicare surprises happens when someone receives a bill and says:
“I thought Medicare covered that.”
Sometimes Medicare did cover part of the service but, many times, the surprise comes from something simpler — the service is one Medicare commonly does not cover at all.
Medicare was designed to cover medical care, not every health-related service people were used to having under employer insurance. Knowing where Medicare draws the line helps prevent frustration and unrealistic expectations.
Commonly Excluded Services Under Medicare
Below are services people are often surprised to learn are not covered by Original Medicare
1)Dental Care
Medicare generally does not cover routine dental services, including:
● Cleanings
● Fillings
● Dentures
● Most extractions
Dental coverage is one of the most commonly assumed benefits — and one of the most misunderstood gaps.
2)Vision Care
Medicare typically does not cover:
● Routine eye exams
● Eyeglasses or contact lenses
(Exception: certain services following cataract surgery.)
Many people assume vision works like other medical visits, but routine vision care is usually excluded.
3)Hearing Services
Medicare does not cover:
● Hearing exams for fitting
● Hearing aids
This often comes as a surprise, especially since hearing loss is common as people age.
4)Long-term Care and Custodial Care
Medicare does not cover long-term care, including:
● Nursing home stays for custodial care
● Memory care
● Help with bathing, dressing, or eating
This is one of the largest and most costly misunderstandings about Medicare.
5)Prescription Drugs
Prescription medications are not covered under Original Medicare Parts A and B.
Drug coverage is handled separately through:
● Medicare Part D plans, or
● Medicare Advantage plans with drug coverage
Without separate drug coverage, medication costs can add up quickly.
6)Cosmetic Surgery
Medicare does not cover cosmetic procedures unless they are medically necessary to restore function. Purely elective cosmetic surgery is excluded.
7)Chiropractic Care
Medicare covers very limited chiropractic care.
It generally covers only:
● Spinal manipulation for subluxation
Most other chiropractic services are not covered.
8)Acupuncture and Alternative Therapies
Medicare generally does not cover alternative therapies. There are limited exceptions, such as acupuncture for certain conditions, but broad coverage should not be expected.
9)Routine Foot Care
Medicare typically does not cover routine foot care, such as:
● Nail trimming
● Callus care
Coverage usually applies only when foot care is medically necessary due to certain conditions.
10) Care Received Outside the United States
Original Medicare generally does not cover routine medical care received outside the U.S. This often surprises retirees who travel or spend extended time abroad.
What This List Really Means
Seeing this list doesn’t mean Medicare is inadequate. It means Medicare has defined limits. Once people understand what Medicare does not cover, they’re
better equipped to:
● Set realistic expectations
● Plan ahead
● Decide whether additional coverage matters to them
A Clear Takeaway
Most Medicare frustration comes from unclear expectations, not poor decisions. Knowing what Medicare commonly does not cover helps you approach Medicare with clarity instead of surprise — and confidence instead of confusion.
Q & A: Medicare Coverage Gaps
Q1: Does Medicare cover dental, vision, and hearing?
Generally, no. Routine services in these areas are not covered by Original Medicare.
Q2: Does Medicare cover long-term nursing home or memory care?
No. Long-term custodial care is not covered.
Q3: Are prescription drugs covered automatically by Medicare?
No. Drug coverage requires Part D or a Medicare Advantage plan with drug coverage.
Q4: Does a coverage gap mean I made a mistake?
No. These are standard Medicare exclusions, not enrollment errors.
