What Does Medicare Not Cover?

What Does Original Medicare Cover?

Original Medicare is broken into two aspects: Medicare Part A and Medicare Part B. 

Medicare Part A is hospital insurance, which typically covers inpatient care in a hospital, nursing home care, home health care, hospice care, and skilled nursing facility care. Medicare Part B is medical insurance, which typically covers services that are deemed medically necessary as well as preventive and screening services. Covered preventive and screening services include: 

  • Abdominal aortic aneurysm screening
  • Alcohol misuse screenings & counseling
  • Bone mass measurements (bone density)
  • Cardiovascular disease screenings
  • Cardiovascular disease (behavioral therapy)
  • Cervical & vaginal cancer screening
  • Colorectal cancer screenings
    • Multi-target stool DNA tests
    • Screening barium enemas
    • Screening colonoscopies
    • Screening fecal occult blood tests
    • Screening flexible sigmoidoscopies
  • Depression screenings
  • Diabetes screenings
  • Diabetes self-management training 
  • Flu shots
  • Glaucoma tests
  • Hepatitis B shots
  • Hepatitis B Virus (HBV) infection screening 
  • Hepatitis C screening test
  • HIV screening
  • Lung cancer screening
  • Mammograms (screening)
  • Nutrition therapy services
  • Obesity screenings & counseling
  • One-time “Welcome to Medicare” preventive visit
  • Pneumococcal shots
  • Prostate cancer screenings
  • Sexually transmitted infections screening & counseling
  • Shots:
    • COVID-19 vaccines
    • Flu shots
    • Hepatitis B shots
    • Pneumococcal shots
  • Tobacco use cessation counseling
  • Yearly “Wellness” visit

What Does Original Medicare Not Cover?

While Original Medicare does cover a lot, there are some gaps in coverage that could be filled by a Medicare Supplement (Medigap) plan or enrolling in Medicare Advantage. The following services are not covered by Original Medicare: 

  • Long-term care, or custodial care
  • Most dental care
  • Eye exams related to prescribing glasses
  • Dentures
  • Cosmetic surgery  
  • Acupuncture  
  • Hearing aids and exams for fitting them
  • Routine foot care 

The following costs are also not covered by Original Medicare but can be covered with a Medicare Supplement plan:

  • Medicare Part A coinsurance
  • Medicare Part B coinsurance or copayment
  • The first 3 pints of blood you need drawn
  • Skilled nursing facility care coinsurance
  • Medicare Part A deductible
  • Medicare Part B deductible 
  • Medicare Part B excess charge
  • Foreign travel exchange

There are also no out-of-pocket maximums with Original Medicare, which can leave you open to financial risk should you experience an unexpected medical event or develop a chronic illness where you require more care.

How To Get More Medicare Coverage

You can get services covered that Medicare doesn’t cover by enrolling in some Medicare Advantage plans. Medicare Advantage plans offer a bundled alternative to Original Medicare and often include extra coverage. 

You can also get costs not covered by Original Medicare covered by enrolling in a Medicare Supplement plan, or Medigap, in addition to Original Medicare. There are multiple different Medicare Supplement plans, and at Kannonball Insurance Solutions, we can help you choose the right plan for your needs.

Get the Medicare Coverage You Need

Kannonball Insurance Solutions is an elite, award-winning agency recognized for choice, value, and convenience. We carefully select our insurance carriers to offer you the best products and services. Contact us today to learn how we can help you get the Medicare coverage you need.