10 surprising things not covered by Medicare and ways you can pay for them

10 surprising things not covered by Medicare and ways you can pay for them

Medicare provides coverage for essential medical services for millions of Americans. From lab tests to physician visits, this health insurance program helps people 65 and older, as well as certain younger individuals with disabilities or specific medical conditions, afford healthcare costs.

However, despite the rise in Medicare spending — which reached over $1,029.8 billion in 2023 — the program still doesn’t cover all healthcare expenses. So you’ll need to plan ahead to determine how you’ll pay for services and supplies that Medicare doesn’t cover.

What services and supplies are not covered by original Medicare (Parts A and B)?

Medicare covers a wide range of services, including mental health support and assistance with managing conditions such as diabetes. But it doesn’t cover all healthcare needs. In this article, GoodRx, a platform for medication savings, outlines 10 things not covered by Medicare — and a few ways to pay for them.

Key takeaways:

• Medicare is a federal health insurance program that covers a range of supplies and services for eligible individuals 65 or older, as well as certain younger individuals with disabilities or specific medical conditions.
• Medicare doesn’t cover supplies and services that aren’t considered medically necessary, such as cosmetic surgery. The program also doesn’t cover long-term care or most dental services.
• You can visit the Medicare website, review your “Medicare & You” handbook, or call the agency directly to get a better idea of what’s covered.

1. Most dental care

Of the more than 36 million Americans who have lost all their natural teeth, the vast majority of them use dentures. Unfortunately, original Medicare — Part A and Part B — does not cover major dental equipment and procedures, such as dentures and root canals, which can cost thousands of dollars. The program also doesn’t cover routine dental checkups, cleanings, or X-rays. 

Medicare will pay only for dental procedures that are deemed medically necessary and connected to the treatment for a larger health issue, such as certain types of jaw reconstruction surgery. To save on dental care services not covered by Medicare, you can:

• Consider signing up for a dental savings plan.
• Use the tax-advantaged funds in a health savings account (HSA) or flexible savings account (FSA) to pay for qualifying dental expenses.
• Visit a dental school or community health center for free or low-cost services.

2. Weight-loss medications

Ozempic, Wegovy, and Mounjaro have become popular medications for weight loss. But many health insurance plans, including Medicare, don’t cover these medications when they’re taken solely for that purpose.

The Medicare Prescription Drug, Improvement, and Modernization Act (MMA), which went into effect on Jan. 1, 2006, prohibits Medicare from covering medications taken to treat obesity. But if you are prescribed one of these medications to treat a qualifying health condition, Medicare may cover it under Part D.

Here are ways to save on weight-loss medications without Medicare:

• Find out if you can use your HSA or FSA funds to pay for your prescription.
• Ask your healthcare professionals for free samples.

3. Long-term care

Long-term care services — such as assistance with dressing, eating, and bathing — are not covered by Medicare or Medicare supplemental insurance, known as Medigap. These types of services fall under personal care services instead of medical services, according to Medicare.

Ways to save on long-term care services without Medicare include:

• Find out if you qualify for Medicaid, which may cover your long-term care.
• Consider purchasing long-term care insurance before you need it.
• If you qualify for health benefits through the U.S. Department of Veterans Affairs (VA), see if you can receive coverage for long-term care. 

4. Most vision care

Original Medicare typically doesn’t cover vision-related healthcare costs, such as eyeglasses, contacts, or routine eye exams. There are a few exceptions, however. For example, Medicare does cover cataract surgery if it’s deemed medically necessary and meets other requirements.

To save on vision care that isn’t covered by Medicare, you can:

• Consider purchasing vision insurance.
• Use an HSA or FSA to pay for qualifying vision expenses.
• Sign up for a Medicare Advantage plan that provides vision benefits.

5. Hearing care

While Medicare Part B may cover your visit to the audiologist once every 12 months, original Medicare does not cover hearing aids or related exams or fittings. But if your healthcare provider orders a diagnostic hearing and balance exam to determine if you need medical treatment, the cost will be covered under Medicare. 

Some ways to save on hearing aids include:

• Claim the hearing aids on your tax return if you itemize your deductions.
• Consider enrolling in a Medicare Advantage plan that covers hearing aids.
• Check to see if your state Medicaid program covers hearing aids and if you’re eligible for coverage.

6. Cosmetic surgery

As you age, you might consider procedures such as a facelift, eyelid surgery, or Botox. Medicare doesn’t cover these procedures for cosmetic purposes. But if you need one to treat a medical condition, such as impaired vision as a result of sagging eyelids, Medicare would probably cover it. 

Ways to pay for cosmetic surgery without Medicare coverage include:

• Ask your surgeon about financing plans.
• Set aside money in your personal savings account for the procedure.
• After weighing the pros and cons, consider signing up for a medical credit card.

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7. Foot care

While Medicare covers medically necessary foot treatments prescribed by a healthcare professional, the program doesn’t cover expenses related to routine foot care, such as:

• Removal of calluses or dead skin
• Nail trimming or removal
• Foot soaks
• Preventive maintenance services

To pay for foot care that isn’t covered by Medicare, you can:

• Set aside money in your personal savings account for foot care expenses.
• Find out if you can use HSA or FSA funds to pay for the supplies or services.
• Weigh the pros and cons of a medical credit card and consider signing up.

8. Adult diapers

If you find it hard to control your bladder as you age, you may benefit from using adult diapers. But Medicare does not cover the cost of adult diapers or other incontinence supplies. Under Medicare, these items are considered to be for personal hygiene purposes rather than medical treatment. 

If you need help paying for adult diapers, you can:

• Check to see if your state Medicaid program covers incontinence supplies and if you’re eligible for coverage.
• If you receive VA health benefits and you’ve been diagnosed with incontinence, ask about getting coverage for incontinence supplies.
• Weigh the pros and cons of a medical credit card and consider signing up. 

9. Deductibles

Both Medicare Part A and Part B have annual deductibles. As with any insurance policy, you have to meet these deductibles before your coverage kicks in. In 2025, for example, the deductible for Medicare Part B was $257. 

Here are some ways to save money on deductibles:

• Shop around and compare health insurance plans.
• Use HSA funds to pay for expenses that go toward your deductible..
• Take advantage of preventive services covered by your insurance plan.

10. Direct primary care membership fees

Medicare does not generally cover the monthly or annual fees you pay a healthcare professional under a direct primary care (DPC) model. Through DPC, you pay your healthcare professional directly for routine visits, basic labs, and preventive care instead of going through insurance.

As of Jan. 1, 2026, DPC is officially recognized as a qualified medical expense under federal law. Due to the One Big Beautiful Bill Act (OBBBA), you will be able to use your HSA to pay for DPC membership fees tax-free if you meet certain requirements.

Getting supplemental coverage through Medicare Advantage or Medigap

If you’re worried about the costs of services that Medicare doesn’t cover, you may want to consider signing up for Medicare Advantage or a Medigap supplemental plan. These options can help pay for out–of-pocket expenses, such as copays, coinsurance, and deductibles. In some cases, you may receive extra benefits such as dental, vision, or hearing coverage. It’s important to compare plan options each year to make sure your coverage still fits your healthcare needs and budget.

Where can I find out if a test, medical item, or service is covered by Medicare?

If you are wondering if Medicare covers a specific item or service, you can refer to the resources below:

• Your “Medicare & You” handbook: Every fall, Medicare mails out an updated “Medicare & You” handbook to beneficiaries. This guide contains information about health plans, benefits and coverage, beneficiary rights, costs, and more. If you don’t receive the “Medicare & You” handbook in the mail, you can download a copy anytime on the Medicare website.
• The Medicare website: On the Medicare website, there’s a search tool that you can use to find out if a test, item, or service is covered. Type in a keyword, and you will receive information about what Medicare covers, in addition to requirements, limits, and costs. If you can’t find information about an item or service, talk to your healthcare professional or contact a Medicare representative to learn more.
• A Medicare representative: If you have questions about coverage, you can call Medicare at 1-800-633-4227, or 1-800-MEDICARE. Representatives are available 24 hours a day to talk or live-chat.

What options do I have if Medicare doesn’t cover my procedure or service?

If Medicare doesn’t cover a procedure or service, here are some options to consider:

• Ask your healthcare professional about payment options. Find out if your healthcare professional offers sliding-scale fees, payment plans, or discounts for self-pay.
• See if you qualify for Medicaid. If you have limited income, you may be eligible for Medicaid. Eligibility varies by state, so it’s important to check with your state’s Medicaid program to determine requirements and coverage options. If you qualify for both Medicaid and Medicare, you may be able to pay less out of pocket for healthcare expenses.
• Submit an appeal. If Medicare denies you coverage and you believe it was an error, you can appeal the decision. You can increase your chances of winning a Medicare appeal by following the specific directions for the appeals process, including your Medicare number on all documents you submit, and maintaining copies of all documents you submit.
• Consider joining a clinical research study. Medicare may help pay for some of your costs if you join a clinical research study to diagnose or treat your condition.
• Look into financial assistance programs. If you meet the requirements, you may be eligible to get financial assistance from the hospital or healthcare facility where you receive the procedure or service. Contact your facility to ask about assistance programs. 

Frequently asked questions

What is the difference between Medicare Parts A and B?

Medicare Part A is often called hospital insurance. It covers inpatient hospital care, skilled nursing facilities, hospice, and some home health services. Medicare Part B covers outpatient care. This includes visits to healthcare professionals, lab tests, and preventive services. Most people don’t pay a premium for Part A, but almost everyone pays a monthly premium for Part B. 

What’s the difference between Medicaid and Medicare?

Medicare is a federal health insurance program mainly for people 65 and older or those with certain disabilities, regardless of income. Medicaid, on the other hand, is a state and federal program that provides free or low-cost health coverage to people with limited income and resources. Some people qualify for both programs, which is known as dual eligibility.

The bottom line

Medicare provides essential health coverage for adults 65 and older and certain younger individuals with disabilities or specific medical conditions. But there are various services and supplies — such as hearing aids, weight-loss medications, and most vision and dental care services — that aren’t covered. Knowing how to save on these items can help you afford your healthcare costs — even for items and services not covered by Medicare.

This story was produced by GoodRx and reviewed and distributed by Stacker.