Everyday care
Some dental, vision, and hearing services are excluded.
Coverage gaps
Know the gaps.
Make room for life.
A clearer view of what Medicare leaves out.
A little clarity. More room for life.At a glance
Start with these three things.
Long-term needs
Most custodial long-term care is not covered.
Extra coverage
Check benefits, limits, and costs individually.
Your questions, unpacked
Coverage gaps: your questions, answered.
01Begin with Original Medicare
Original Medicare does not cover some services, including most dental care and routine eye examinations. Coverage can depend on the medical circumstances and the type of service.
It generally does not cover care outside the United States, with limited exceptions. If you travel, ask how your particular coverage handles emergencies.
02Look closely at additional benefits
Some Medicare Advantage plans offer extra benefits, such as certain dental, vision, or hearing services. Availability, limits, networks, and costs vary by plan.
A benefit can have an allowance or restrictions. Ask what happens after an allowance is used and which providers you can visit.
03Separate coverage from cost sharing
Medigap generally helps pay certain out-of-pocket costs for services covered by Original Medicare. It is not a promise that every excluded service becomes covered.
List your priorities, then ask which coverage addresses them and where you may still need to budget for costs yourself.
04Plan for long-term care separately
Medicare generally does not cover long-term custodial care when help with daily activities is the only care you need. Certain skilled services may be covered when Medicare’s conditions are met.
Routine dental care, hearing aids, and many vision services also call for a separate coverage and budget check.
Sources & further reading
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