What does Medicare not cover?

Original Medicare (Parts A and B) does not cover routine dental, vision, or hearing care; long-term custodial care; most care outside the U.S.; cosmetic procedures; or most prescription drugs (which require a separate Part D plan). These gaps are why many people add a Medigap supplement or choose Medicare Advantage.

Educational content — not insurance advice

ClearValue Lending is not affiliated with, endorsed by, or connected to Medicare, CMS, or any government agency. This page is general financial education, not insurance advice. For questions about your specific coverage or options, visit Medicare.gov, call 1-800-MEDICARE (1-800-633-4227), or contact a free SHIP counselor at shiphelp.org.

Medicare covers a substantial range of medical services, but it was never designed to cover everything. Understanding what it does NOT cover helps you plan for out-of-pocket costs and evaluate whether supplemental coverage makes sense. The Medicare.gov coverage overview is the authoritative reference for what is and is not included.

Routine dental, vision, and hearing

Original Medicare (Parts A and B) does not cover routine dental exams, cleanings, fillings, dentures, or tooth extractions. It does not cover routine eye exams or glasses (with a narrow exception for post-cataract surgery eyewear). It does not cover routine hearing exams or hearing aids. These are among the most common coverage gaps Medicare beneficiaries encounter. Some Medicare Advantage (Part C) plans offer dental, vision, and hearing benefits — but these vary widely by plan and location. Verify specific plan benefits at Medicare.gov Plan Finder.

Long-term custodial care

Medicare covers skilled nursing facility (SNF) care only under specific conditions: you must have had a qualifying hospital inpatient stay of at least 3 days, and the SNF care must be for skilled services (physical therapy, wound care, IV medication management). Medicare does not cover custodial care — help with activities of daily living such as bathing, dressing, and eating — which is what most people need in a nursing home or assisted living setting. Long-term custodial care is primarily funded by private long-term care insurance, personal assets, or — for those who qualify — Medicaid. KFF (Kaiser Family Foundation) provides a thorough breakdown of Medicare's skilled-care limits.

Most care outside the United States

Medicare generally does not pay for health care you receive outside the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa. There are narrow exceptions — for example, if you are in the U.S. and the closest accessible hospital is in Canada. If you travel internationally, travel health insurance or a Medigap Plan C, D, F, G, M, or N (which includes a foreign travel emergency benefit) may provide limited coverage. The Medicare.gov travel page has current guidance.

Prescription drugs (without Part D)

Original Medicare (Parts A and B) does not cover most outpatient prescription drugs. Part A covers drugs administered during a covered inpatient hospital stay; Part B covers a limited set of drugs administered in a clinical setting (e.g., chemotherapy, injections given at a doctor's office). All other outpatient prescriptions require a separate Medicare Part D Prescription Drug Plan or a Medicare Advantage plan that includes drug coverage.

Other notable exclusions

Cosmetic surgery (unless required to repair injury or treat illness — the exception is narrow).
Acupuncture (limited Medicare coverage exists for chronic low-back pain only, under specific conditions).
Routine foot care (nail trimming, callus removal) — though diabetic foot care may qualify under Part B.
Most chiropractic care beyond spinal manipulation for subluxation.
Personal comfort items (private hospital rooms, phone, TV).
Most preventive care tests and screenings not specifically approved by Medicare — see the Medicare preventive services list.

CMS and KFF sources

Original Medicare does not cover routine dental care and most dental procedures, routine eye exams and most eyeglasses, hearing exams and hearing aids, or most prescription drugs taken at home. — Medicare.gov — What Medicare Covers
Medicare covers skilled nursing facility (SNF) care for a limited time after a qualifying hospital stay. It does not cover long-term (custodial) care — help with activities of daily living like bathing, dressing, and eating. — Medicare.gov — Skilled Nursing Facility Care
Medicare generally does not cover health care you receive outside the 50 United States and U.S. territories, with only narrow geographic exceptions. — Medicare.gov — Travel Coverage Outside the U.S.
According to KFF, an estimated 70% of people who reach age 65 will need some form of long-term services and supports during their lifetime — most of which Medicare does not cover. — KFF — What Does Medicare Cover? A Primer

Key takeaways

Original Medicare does not cover routine dental, vision, or hearing — three of the most common out-of-pocket costs for seniors.
Long-term custodial care (nursing home, assisted living) is not covered — plan for this separately.
Prescription drugs require a separate Part D plan or a Medicare Advantage plan with drug coverage.
Some Medicare Advantage plans offer dental, vision, and hearing benefits not in Original Medicare.
Review the full coverage list at Medicare.gov — it updates as CMS expands or adjusts covered services.