Learn what Medicare doesn’t cover and what you can do about it
Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with permanent kidney failure requiring dialysis or a transplant.
You can also find out on our site what Medicare covers, but this page specifically deals with what Medicare does not cover…. and what you can do about it.
What does Medicare not cover?
- Basically 20% of all your medical costs. (Medicare usually pays 80% so you pay 20%)
- Any deductible, copay or coinsurance
- Prescription Drugs
- Vision
- Dental
- hearing
- First 3 pints of blood
- Foreign emergency healthcare
For a more exensive list of what Medicare does not cover, scroll to chart at the bottom of this page.
It can be a worrisome list of items that Medicare coverage completely cover. Good news is that you can still get those items covered.
How to address what Medicare doesn’t cover?
Get additional coverage by enrolling in a Medigap plan, a Medicare Advantage plan, and/or a Part D Drugs plan.
You can get a quote here.
Medicare Fee Details
| Benefits | What Medicare Makes You Pay |
|---|---|
| Part A Hospital Benefit Period Deductible | You pay $1,676 |
| Hospital days 61-90 | You pay $419 |
| Hospital Days 91-150 | You pay $838 (lifetime reserve days) |
| Beyond Lifetime Reserve Days | You pay 100% off all costs |
| Skilled Nursing Facility Care Days 1-20 | You pay $0 (Part A deductible applies)** |
| Skilled Nursing Facility Care Days 21-100 | You pay $209.50 per day |
| Hospice Respite Care | You pay 5% |
| First 3 Pints of Blood | You pay 100% of all costs |
| Additional Blood | You pay $0 |
| Part B Annual Deductible | You pay $257 |
| Ambulance | You pay 20% (Part B deductible applies) |
| Doctor Office Copays/Coinsurance | You pay 20% (Part B deductible applies) |
| Durable Medical Equipment | You pay 20% (Part B deductible applies) |
| Part B Excess Charges | You pay 100% (Part B deductible applies) |
| Foreign Travel Emergency | You pay 100% |
| Out-Patient Surgery | You pay 20% (Part B deductible applies) |
| Urgent Care | You pay 20% (Part B deductible applies) |
| Dental | You pay 100% |
| Vision | You pay 100% |
| Hearing | You pay 100% |