Millions of older Americans today get health coverage through Medicare. And without it, they’d potentially be facing even larger medical bills.

But while Medicare might pick up the tab for most of your care in retirement, there are a number of key services it won’t pay for. And it’s important to know what those are so you can plan accordingly.

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Four key items not covered by Medicare

Medicare will pay for a hospital stay, diagnostic tests, vaccines, and more. But these four things are ones Medicare will not cover:

• Eye exams and glasses
• Heating exams and aids
• Dental care
• Long-term care

Given how essential these services can be for seniors, you may find it shocking to learn that Medicare won’t pay. But if you enroll in original Medicare, you’re on your own for these costs.

How to get the coverage you need

If you’re worried about paying for the items above in retirement, know that just because original Medicare won’t pick up the tab doesn’t mean you won’t fare differently with a Medicare Advantage plan.

Medicare Advantage is an alternative to original Medicare you can sign up for as a senior. Advantage plans commonly work like the private insurance a lot of people have during their working years. And the good thing is that Advantage plans have to offer at least the same level of coverage as original Medicare.

Most Medicare Advantage plans, however, offer a good number of supplemental benefits beyond what original Medicare does. And as of 2024, 99% of Medicare Advantage plans paid for eye exams and glasses, while 98% covered dental care and 96% offered hearing exams and aids as a benefit, according to the Kaiser Family Foundation.

Meanwhile, if you want coverage for long-term care, that’s something you’ll probably need to buy insurance for. Medicare Advantage plans commonly don’t cover long-term care.

Long-term care insurance won’t necessarily cover 100% of the cost of a home health aide, assisted living facility, nursing home, or other service you need that falls under that umbrella. But you may find that a policy covers a substantial portion of your annual bills, which could otherwise be enormous. The average cost of an assisted living facility, for example, was $64,200 as of last year, according to Genworth.

Of course, the problem with long-term care insurance is the cost involved. But if you’re worried about unaffordable premiums, apply early. If you put a policy in place during your 50s, you may be more likely to get a discount based on your age and health.

Though Medicare is a helpful program for millions of seniors, its coverage may be more limited than you’d expect. It’s important to familiarize yourself with the things Medicare will and will not pay for to avoid unpleasant financial surprises in retirement. And also, the more you know about Medicare’s limits, the more you can plan accordingly, whether that means exploring your options for coverage with a Medicare Advantage plan or shopping around for long-term care insurance well ahead of when you might need it.

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