What Original Medicare Won’t Cover in 2026

Original Medicare, which includes Parts A and B, covers a variety of medical services once you reach 65, but it doesn’t cover everything. If you find yourself needing specific services that fall outside of this coverage, you may have to pay out of pocket unless you have supplemental insurance or are enrolled in a Medicare Advantage plan that offers added benefits.

Here’s a breakdown of some medical services that original Medicare will not cover:

• Dental Care: Routine dental services like exams, cleanings, x-rays, fillings, extractions, and dentures are not covered.
• Vision Care: Medicare does not pay for routine eye exams, glasses, or contacts (except post-cataract surgery). However, it does cover treatments for specific eye diseases such as glaucoma or cataracts.
• Hearing Aids: You won’t find coverage for hearing aids or hearing tests. Medicare might cover balance and hearing tests if deemed necessary by your doctor.
• Prescription Drugs: Original Medicare doesn’t cover outpatient prescription drugs, but you can opt for a separate Medicare Part D plan to help with these costs.
• Alternative Medicine: Services like acupuncture (beyond lower back pain) and chiropractic care, aside from specific spinal corrections, are not covered.
• Cosmetic Surgery: Most cosmetic procedures are not eligible for coverage, although surgery related to injury or deformity may be covered, such as breast implants for cancer survivors.
• Foot Care: Routine foot care is generally excluded. Yet, Medicare does cover certain podiatrist services for medical issues like bunions or hammertoes, along with shoes for those with diabetic foot problems.
• Long-term Care: Services in nursing homes or assisted living facilities are not covered. Some skilled nursing care may be funded after a qualifying hospital stay.
• Home Health Care: Help with daily living activities like bathing or dressing isn’t typically covered unless you’re receiving skilled care and are homebound. General household services aren’t covered either unless under hospice care.
• Incontinence Supplies: Items like adult diapers aren’t covered as Medicare views them as personal hygiene products rather than medical necessities.
• Overseas Medical Care: Medical treatment outside the U.S. is largely not covered unless in specific scenarios, like emergencies on cruise ships close to U.S. ports.

It’s wise to consult with your healthcare provider for clarity on what’s included in your Original Medicare plan. Additionally, even when coverage exists, it doesn’t necessarily mean Medicare pays for the entire expense. For instance, most beneficiaries will need to consider a monthly premium for Part B, which is projected to be $202.90 in 2026. Along with that, you’ll likely face deductibles and copays unless you have additional insurance. However, preventive services are usually fully covered without any added cost.

If you have more questions or thoughts, feel free to reach out!