Part A and Part B – What’s Not Included

Part A (Hospital Insurance) and Part B (Medical Insurance) coverage will help cover medical expenses for Medicare beneficiaries, but, unfortunately there are certain benefits that you would have to pay for “out-of-pocket.” In these cases, you have the option to simply pay for the services or supplies yourself, or you can consider your healthcare coverage options and hopefully find additional coverage that would include the coverage you need.

Part A includes coverage for hospital care, skilled nursing care, hospice, and home health services. Part B covers medically necessary services and supplies and some preventive services. Part B coverage helps cover the costs of durable medical equipment (DME), ambulance services, a second opinion before surgery, clinical research, and mental health care.

There are costs that most Medicare beneficiaries are responsible for, including deductibles and copayments, but if you have Original Medicare, you may consider a Medigap plan to help cover some of those costs. There are services not covered by Part A and Part B, including the following:

  • Long-term care (also called custodial care)
  • Routine dental or eye care
  • Dentures
  • Cosmetic surgery
  • Acupuncture
  • Hearing aids and exams for fitting them
  • Routine foot care

If these services are important to you, you may find Medicare Advantage Plans that include some of those services, including vision or dental care, hearing exams, and even fitness club memberships. There may still be services that you must pay out-of-pocket for, so after choosing the Medicare health insurance that will best suit your needs, make sure you examine your budget and plan accordingly.