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To avoid any future health care surprises, can you tell me what original Medicare does not cover in 2026?
While original Medicare (Parts A and B) covers a wide array of health care services after you turn 65, it does not cover all your needs. If you need or want certain services that are not covered, you will need to pay for them yourself unless you have other insurance or are enrolled in a Medicare Advantage health plan. Here is an overview of essential medical services that original Medicare does not cover. This list may not be fully comprehensive, so it is always advised to check your plan documents.
Most dental care: Original Medicare does not cover routine dental care including checkups, cleanings, x-rays, fillings, root canals, tooth extractions and dentures.
Routine vision care: Medicare does not cover routine eye exams, eyeglasses or contact lenses except following cataract surgery. However, Medicare does cover tests, treatments and surgeries for eye diseases like cataracts, glaucoma and macular degeneration.
Hearing aids: Original Medicare will not pay for hearing exams or hearing aids but may cover a hearing and balance exam if your doctor determines it is medically necessary.
Prescription drugs: Medicare (Parts A and B) does not cover outpatient prescription medications. However, you have the option to buy a separate Part D prescription drug plan that helps cover these costs.
Alternative medicine: Acupuncture, chiropractic services and other types of alternative or complementary care are not covered by Medicare. There are some exceptions, however, including acupuncture to treat chronic low back pain and services to correct a vertebral subluxation of the spine.
Cosmetic surgery: Most cosmetic procedures are not covered. Some exceptions exist and require prior authorization. Some services may be covered, such as those related to an injury, illness or deformity. For example, Medicare will cover breast reconstruction for breast cancer patients who have had a mastectomy.
Foot care: Medicare does not cover most routine foot care, like the cutting or removing of corns, calluses or toenails. Medicare will provide coverage for podiatrist services that are medically necessary for foot problems such as hammertoes, bunions or heel spurs. Coverage includes examinations, treatments and therapeutic shoes or inserts for individuals suffering from diabetes-related foot problems.
Long-term care: Nursing home care and assisted living facilities are not usually covered by Medicare. Medicare will help pay for up to 100 days of skilled nursing or rehabilitation care immediately following a hospital stay of three or more days.
Personal home care: If you need to hire help with bathing, dressing or getting out of bed, Medicare will not usually cover these costs unless you are homebound and are also receiving skilled nursing care. Housekeeping services, such as shopping, meal preparation and cleaning, are not covered either unless you are receiving hospice care.
Adult diapers: Medicare does not cover the cost of adult diapers or other incontinence supplies since these items are for personal hygiene rather than medical treatment.
Overseas coverage: Health care services outside of the United States are not included under Medicare except in very limited circumstances. For instance, it covers services received when on a cruise ship that is within six hours of a U.S. port.
The best way to find out what original Medicare covers is to talk to your health care provider, visit Medicare.gov/coverage and search for your test, item or service in the search box, or download the Medicare “What’s covered” app from the App Store or Google Play.
It is important to remember that, although Medicare may cover a service or item, it does not fully pay for the entire cost. Those enrolled in Medicare pay a monthly Part B premium, which is $202.90 for most beneficiaries in 2026. In addition, unless you have supplemental insurance, you will have to pay your annual deductibles and copayments. Nonetheless, most preventive services are fully covered by Medicare without any copays or deductibles.
Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.
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