5 Things Medicare Doesn't Cover (and how to get them covered) 

So the elderly sit there at home toothless, blind, deaf, sick, but hey, there's medicare that you must buy. What a racket!!!!

The rising cost of insurance, healthcare, groceries, and housing is forcing seniors to live on the streets. This is outrageous. You spend 30 years or more of your life working and your reward: poverty

Dental Care not being covered by Medicare and many Healthcare Insurance Plans is very short sighted. Many health problems are caused by poor dental hygiene.

Thank you ! No Soc. Sec. coverage for dental and eyes is criminal negligence !

So, medicare doesn't cover anything that the elderly needs. Imagine that.

1) Vision care 2) hearing aids 3) Dental services 4) Annual physical exam 5) Nursing home or long term care

Poor elderly people are treated like crap, so sad 😢

My parents turned 65 when I was 18. I filled out the forms and signed both of them up for Social Security and Medicare. It took a total of four forms. But that was before for-profit corporations got involved. I spent two years researching Medicare advantage. I like what I have OK, but if something isn't covered, I go without it. That's what everyone has to do in this capitalistic hellhole. Always remember: people do not matter in "healthcare;" profits do.

These 3 things are exactly what Seniors need much more than others- Hearing Aids, Dental Implants and Eyeglasses. Seems Cruel not to cover these.

I have recently retired, it surprised me that I pay 178$ a month for Medicare and it barley covers anything. I bought a good advance plan that pretty much picks up everything Medicare does not,Im happy for that. You’d think as we age and all we’ve paid in through the years that Medicare would pay for more.

Here’s a good one. I was in the hospital for a month after almost dying of septic shock. My kidneys were damaged because of it and I was placed on dialysis. After the month I was transferred to a rehab facility to learn to walk and care for myself. Transportation to and from the dialysis facility was not covered by Medicare. I was in a wheelchair. How was I supposed to get there, walk?

I worked in healthcare for 40+ years. Our healthcare institutions are a prime example of American capitalism and greed at it's best. It's a huge money-making machine. We, as a society have long forgotten about our moral duty to take care of it's citizens in the best way possible. If this is the best we can do then we need to think harder about how to change it.

Stephanie, I learned early on from personal experience that a simple comparison between Supplements and Medicare Advantage plans is this: Medicare Advantage Plans leave the decision of what medical treatments are allowed to the insurance company, while Supplement Plans leave those decisions to you and your physician. I like it better when I and my doctor decide what treatment protocol is best for me.

I just retired from a job that had very good health insurance, and now I see the big difference. Being on Medicare is big learning experience and eye opener.

Welcome back and thanks for keeping it simple. Traditional Medicare doesn’t cover vision, hearing, dental, and the old folks’ home. You need to be specific, when you go to your doctor and ask for a Medicare Wellness exam.

My doctor when I was growing up told me that routine physicals were mostly for people without chronic problems. He saw them as a way to catch problems before they became serious. For those of us with chronic illnesses, those physicals may be unnecessary. I always find out from my docs why they need to do a test and why they need to see me again. I’ve avoided unnecessary costs by doing that. I find the annual wellness checks to be a bit of a joke. All my doc does is go over the meds I take, my allergies to medications, and any new diagnoses. Those are addressed every time I see any doctor, which I do many times per year. Those wellness checks are a waste of effort, time, and money for me. I think it’s ridiculous that three of the things that all people on Medicare need aren’t covered. Vision, dental, and hearing should be included in basic Medicare. Perhaps it’s because we all need them that they aren’t covered. In my experience, insurance generally covers the unexpected rather than the basic needs.

My dad and my brother thought my dad was developing dementia. It turned out that the problem was he couldn't hear in certain ranges and this made it impossible to follow conversations, tv shows or movies. It was not like the movies where someone asks you to repeat something because they couldn't hear a word. He did not even realize that he could not hear well. He thought he was losing his ability to process what people said. We also found out that there are a lot of scams out there related to hearing aids that target the elderly.

My annual physical has shown the beginning of problems that my doctor and I can work on when the issues are small and curable. I can't believe Medicare doesn't cover annual blood work. I have always been covered for that since my 20s at an annual physical. One would think blood work is more important when one is elderly.

It doesn't make sense that Medicare doesn't cover vision, dental, hearing needs for older people. Those are the areas that begin to fail as we get older. Those are the needs we have.

Happy new baby and thank you for this video! no one can afford long term care and we need more ideas for this!

After moving from one state to another, I found that some things are covered differently than in my former home. I find that really outrageous. My previous agent fought hard to get insulin covered in full and I was thankful for that diligence. Two pharmacists here tell me that’s not possible in my new home. Why, I’m an American citizen over 65 both places. ???

They cover vision care IF it's medical treatment for an issue or disease but NOT regular eye exams for glasses.

This channel is hands down the best, most comprehensive yet easily understandable explanation of all medicare information. Nice surprise with the adorable little ones at the end 💓

Mrs. Abt, I've just come across your videos and you are GREAT! Many retirees need to know this information. Thank you for your educational and instructional videos.

I worked for a Fortune 100 company that never covered Vision, Hearing Aids or Dental under their healthcare insurance. These were always extra. I always did my research to compare my company's offerings & cost and to what I could get elsewhere or deals available. Thus, I won't have expected Vision, Hearing Aids or Dental under Medicare (Part A & B). The Medicare Annual Routine Physical Examination would be equivalent to what I had from my company's insurance that covered a Wellness Check. I'm glad that you pointed these out so I could be prepared. Thank you

Beautiful Family! Have followed you for over a year! You talk and explain so simply!

Great video! Nice family! Beautiful kids! THANKYOU for doing what you do.

Thank you for your accurate and concise information and wisdom about Medicare. When it comes to healthcare, let the buyer beware.

A couple more things; They don't cover elastic garments or supports. For instance, compression stockings, gloves, or arm sleeves to control edema (fluid retention). Orthopedic shoes or braces. Use of a treatment room for minor procedures. Insulin. Many other things that have a nasty surprise bill after the fact and no one warned you.

A lot of you guys advise to not sign up for an advantage plan, and I do agree with the reason why. However, advantage plans usually cover all this. So, if you purchase medigap, vision, dental and hearing aids plan, it comes to about $350 a month. Many can’t afford that, so , as it is always, it’s all about THE MONEY!! It’s a shame!!!

Stephanie, I just watched this video and there is a 6th thing that you should tell your audience. Insulin is the most expensive drug that you have to buy. While working and having Group Health Care Coverage, I paid 'Out the nose' for Insulin. I have had a Medtronic Insulin Pump for the past 14yrs. In 2019, my Medtronic rep told me that I should not be submitting my insulin, along with all the other supplies under my Medicare Part D plan The key is to submit it under Medicare Part B. Yep, that's right. The insulin pump is a 'SYSTEM.' The SYSTEM consists of: - The Insulin Pump - The Reservoirs (Insulin reservoir) - The Quick Sets (The tap that is inserted for 3-Days) - The INSULIN - The Lancets - The Test Strips If anyone of those pieces are missing, you do not have a 'Complete System.' Now, Medicare just DOES NOT like paying for Insulin Pumps, Insulin, etc. Before one goes on Medicare, they should ask their Endocrinologist to put them on the PUMP. Medicare will kick, wiggle and scream to pay for these items. Medicare requires that you have to take a C-Peptide test which measures how much insulin your body produces. It is IMPORTANT to fast for at least two days before taking this test. AVOID eating carbohydrates that is what triggers high blood sugar an insulin production. I hope you consider researching this and including it in one of your videos. On another subject, I learned last year that without a vision plan I had my eyes examined at Walmart. The exam is generally around $90.00. I was asked if I was on Medicare. The test was only $20.00. Now was this only because I was on Medicare, or was it the combination of being on Medicare and Diabetic. Insulin, Trulicity, Farxiga and Myrbetriq are four of the most expensive drugs to pick up. My doctor put me on Farxiga before I went on Medicare. I had a coupon that said it was FREE for as long as my doctor prescribed it. Oh, so true, but the minute I went on Medicare, the FREE coverage ENDS! Why should Medicare care if the drug company wants to give it to me for $0.00 - Our government at work. 90 Days of Trulicity breaks down to: $3.89 per day ($327.13 - More or less depending on whether you are before-in-or out of the Rabbit Hole) 90 Days of Farxiga breaks down to: $4.86 per day ($437.19 - More or less depending on whether you are before-in-or out of the Rabbit Hole) 30 Days of Myrbetriq breaks down to $3.19 per day ($95.62 - More or less depending on whether you are before-in-or out of the Rabbit Hole) My Urologist told me that the patient on Myrbetriq was supposed to run out this summer. It has not. He has given me 9months of free samples to tie me over. Many older people do not take their medications because of the COSTS!

Hi Stephanie, Great video and good info. One thing about Skilled Nursing Care. Medicare Advantage plans are very quick to kick the person out of the skilled facility if they are not showing improvment. Lately, Original Medicare gives them a little more leeway but they are also cutting them off pretty quickly. Just thought it was worth mentioning. Comes up a lot lately.

Thanks Ma'am!! We appreciate your info videos. It effects us all.

If our politicians worked for America we might have better health care instead of sending Billions for wars where those country have full healthcare coverage.

At age 67, I had a great doctor in SE PA, for 10 years, but she went into a concierge practice for a patient fee of $1,800 a year, so I opted for a new pcp. I have regular Medicare A & B with a supplement plan. At the new patient visit, he sent me for $2000 worth of bloodwork of which I paid almost $300 out of pocket. Plus, I was billed a certain percentage for his visit. He also sent me to a cardiologist for baseline ekg etc. I paid $100 out of pocket for that. Then he required me to come in for an office visit every 3 months to renew a simple hypertension med that I've taken for 25 years! I think doctors paid by Medicare are either required or incentivized to keep their patients on a hamster-wheel of controlled services & medications. I've moved out of state last month and will search for a DO or a doctor who doesn't take Medicare! I'll pay as I go, for an office visit, only when I need to annually or to get Rx refills or when ill. In 25 years, my docs only required an annual checkup to renew the BP Rx, he wants Medicare to pay him 4 times to do that! I don't consent to being on the Medicare hamster-wheel. I'll consider Medicare as catastrophic only.

So happy to hear from you!

Congrats 🎊 on your baby and thank you for helping us to discern among this cloudy mess 😅

Congrats on the new baby Stephanie and thanks for the video!

Thank you, always helpful.

Another fantastic video. Thank you so much!

I have a Medicare Advantage plan. For the most part I am happy with it. It is fairly inexpensive and has covered everything except one prescription for eye drops for cataract surgery prep. The only downside is the doctors they assign you to. Most are focused on preventive medicine. I don't want preventive information. I am 75 and have learned a lot in all those years about how to stay healthy, whether I follow the guidelines or not. I want a doctor to address my current health problems. I don't run to a doctor every week, or month. I only go when I have an issue, which luckily isn't too often. But I do have a chronic back problem. Every time I bring it up it gets ignored. I guess I should have "prevented" it.

I turn 65 in December, and have started my research for coverage. I must tell you even though you explain it very well i am still very confused. Why do they make it so complicated???

Medicare hounded me to sign up, but didn't, I have other medical insurance, these are the 5 most needed medical coverages. ty for this much needed info.

That’s why being in the VA is so important. A vet with a 10 percent rating can get vision care/glasses and hearing exam/aides for free.

Does not cover: 1 Eye exams 2 hearing aids 3 dental services 4 full routine annual exams that include blood work ups. Some parts will cover wellness yearly exams but not “full” routine physical exams. Wellness exams yes 5 Long term custodial care is not covered.

Congratulations on the new addition to the family 🥰

Thank you so much for explaining this very confusing part of medicare.

Congratulations on new baby! Thanks for good and helpful information.

We need to greatly expand Medicaid in this country.🇺🇸

First off congratulations!!! I have Medicare (thru disability, back arthritis) went onto an advantage plan, I'm not 65 yet 63 & a supplemental plans were just too expensive not being 65 yet.

Very good information.. well explained.Thanks for.

Great information once again. Thanks!

Congratulations on your new little one, Stephanie! You look great. Best wishes!

Thanks for another informative video, Stephanie. I'm beginning Medicare August 1 and bought my plans through the Abt Agency! You guys are great. Congrats on the new baby.

excellent and extremely crucial video for learning !!! ..this is really the good to know info before joining either MaPd or traditional plan...awesome! thanks!!

Im on medicare, I can't afford a supplement because my check is so little, my health prevents me from working and I cant afford to go get my medications needed to live. So depressing.

This is a very helpful series of videos! I hadn’t planned to retire-ever-if I stay vital and maintain the skills needed to perform well. Last night, however, the spark of inspiration whispered, “ Just look into it.” I hadn’t even started my research (so no AI involved this time), but your video from a couple days ago popped up on my RU-vid feed just now. 😳 I will no doubt be in touch. Even if I had found this video useless, it would have been worth watching just for that priceless surprise ending!!! 😍

What is the point in having Medicare, it doesn't cover the things the elderly need???

Congratulations on your new baby. Beautiful family! 😍

Great information, thank you. It seems penny-wise, but pound-foolish that Medicare doesn’t cover routine full exams. Early prevention not only saves lives, it saves money. I’m not sure which plan I have (it has a pharmacy plan), but I signed up for one of the Medicare HMO plans, Kaiser Permanente, and it’s really easy, no bills, claim forms, etc. If there is a fee for something, it’s small and collected at the time of service. Dental care is a big issue, though. I have a limited dental plan that is included, but haven’t had the courage to go to one of its discount dentists. I want my own dentist, whom I trust, and don’t want skimpy, rushed or second-rate dental services.

Lots of important information. Thank you!

Have you found any other surprising things that Medicare doesn't cover? How are you getting them covered (or not)? Share your comments below!

I start Medicare December 1 and it’s a darn shame they don’t cover more than what they do……

as someone who works for medicare advantage i can attest it is a great service if you are not constantly ill thats when supplemental insurance is a good stand it instead

Thank you for this great informative video. I will review again later to implement into our retirement plan.

Adorable blessed children! Thanks for the info

There's actually A LOT that Medicare doesn't cover. I wish people advocating for Medicare for All would instead advocate for *enhanced* Medicare for ALL.

Please share this with your young adult children. The younger you are (and assumably healthier) the easier it will be to purchase Long Term Care insurance (Nursing Home care.) My husband and I did not even know something like this existed until my parents both entered a nursing home at the same time! Luckily they had substancial savings, owned their own home, and were debt free. We had a very profitable estate sale, sold their home, and were able to cover their 3 and 5 year stays in the nursing home easily. My husband, who has had cancer twice and I (I have progressive Multiple Sclerosis) could not get nursing home insurance. Our son, age 38, was encouraged to research it and he was able to easily obtain a long term care policy at a very reasonable cost. It’s something to consider!

Thank you! Thank goodness we have vision and dental plans. I did something right!

Thks for the Medicare insights! 💜your adorable fam!

Attention Veterans. The Va is the largest dispenser of hearing aids in the world. Once you are in the VA medical system, you can request a hearing test. If you need hearing aids, there might be 2 or 3 co pays of $50, and you can have state of the art hearing aids. If you had a combat MOS ( Military Occupational Specialty) you might get them for $0 co pay. You can enroll in the VA medical system on line. Do your research. I wanted Phonak Paradise P90's and that's what I got. The retail price is $7500 plus. Being in the VA medical system has no bearing on your Medicare. I use the VA for expensive RX's with a $8 or $11 copay. I get three RX's through medicare with a $2 co pay. VA RX coverage is credible for medicare. For the vast majority of Veterans, the VA is not going to provide dental or vision coverage.

Those averages for long term nursing home care are a lot higher on the East Coast in NYC metro area. More like 200-250K/year. Another thing Medicare does not cover, nor any insurance, is in-home care for the elderly by private home care agencies. I'm using a local agency for my Mom. They have different levels-companion care, where they can't touch the person and nurse supervised care where they can wash/bathe, etc. For 7 day/week-6 hours weekdays and 5 hours weekends, over $70,000/year. I care for Mom most of the time but need help for several hours as I retired, but still do some part time work from home. Nobody tells you about these home care costs for the very late stages of life when you lose the ability to care for yourself when you go to experts in financial planning for retirement.

Congratulations first of all, and thank you for this information.

Thanks for the info. Beautiful family, congratulations on your newest!

I noticed Optometrist charge more to patients with insurance than without. Although I had insurance through VSP, now I tell them I don't have insurance. When I wrrntvthrough VSP, I had to pay a deductible, and the bill was $150. When in say I don't have insurance, a routine exam for glasses, the bill is $35 to $50.

Very informative but the end of the video is cuteness overload. 😄 Sandi

Thank you so much for the information

My dad had hospice care but he owned his home.There were 4 regular nurses that took care of him till he passed at home.

The thing that surprised me was the lifetime fine I have to pay each and every month until I'm dead because I didn't buy Medicare part D when they suddenly sent me a Medicare plan not because I requested Medicare but because if you file for disability and win then you are automatically enrolled. At the time I was taking no medication so saw no point in buying part D. After a few yrs go by I tried to get Medicare advantage and they said the plan was free however you will have to pay the penalty for late enrollment of medication coverage! This was the first I had ever heard of the penalty and I was shocked! Maybe they could find a better way to let folks know and remind them until they know for a fact the customer realizes the drawback to not enrolling in medication coverage ASAP! I'm totally disappointed in the whole mess! The only way out of it be poor yep you can enroll whenever the hell you want as long as your are low income you will never ever pay this fine that I pay every single month oh and it gets better this fine is determined by the average that everyone pays for medication coverage so this fine goes up each yr! This is sick they need to come up with a different setup. If it's so critical you have Medicare part D then include it when you auto enroll those who have won SSD! Shame on you SSD! I don't even see a point in a penalty when the person doesn't take any medication! Why would any person looking to save money buy insurance for something they have not used in yrs? 🤷

My furture plan for long term custodial care is a gallon of vodka, -35 F wind chill, wearing a bathing suit under a freeway overpass. $100K/year is like telling me to hop to the moon 😂

Stephanie, Medicare is so complex to me, I am just now, a year into watching your videos, starting to "get it". NOTE: When I read USA spends 16% GDP on health? It is only now I understand how that number gets jacked up so high. Well, and the army of lobbyists writting our state and national insurance laws. Thanks again for your work to help all of us.

Very informative thank you

I am on an advantage plan that pays for my eye exam & $300 toward glasses - gives a discount on hearing aids -pays $2000 toward dental procedures - includes my drug coverage - of course pays 100% for my annual physical - I have a CPAP and it pays for 80% costs with that . And my monthly premium is zero - yes zero monthly premium.

I get my medical care through the Indian health service and my tribe also provides free hearing aids. But for everyday care , I go to the Indian clinic and get primary care, dental and vision care as well as blood work and prescriptions. It is a misnomer to call it a clinic really. I can get X-rays and ultrasounds, just about anything but surgery. If I ever need surgery I can go to an Indian hospital for that. Medicare is just extra for me.

Holy Cow! I actually understood everything you said! The first time! Thanks for that....

You have a lovely family! Thanks for the information!

I was surprised that not all the blood tests that the doctor ordered were covered. The phlebotomist let me know ahead of time though. Also, still trying to figure out what to call a check up that will go over ongoing medical issues that wouldn´t be a physical.

I have noticed that my Medicare wellness questions are different from my friends who have similar medical conditions as myself. Could you do a video showing the medical wellness questions that your doctor would normally ask her patient? They are asking me questions that have nothing to do with my health. They ask me if I have fire extinguishers in my home, Fire alarms, carbon dioxide dioxide alarms and oh yeah, do I have any guns in my home? Those don't have to do with my health necessarily. Does anyone else have that problem with their doctor asking them questions that do not pertain to their health. They really throw a fit when I refuse to answer. I find it against my rights to answer some of those questions. Thank you for the informative reply video.

Absolutely Wonderful! God bless you and your family ❤️

Congratulations! Beautiful family.

I will return and make note of your tips. Thank you! I got a surprise just this week when I picked up my "bowel prep" prescription for my upcoming colonoscopy. It was not covered by Medicare or my supplemental insurance. It was $116.

Well after retiring and going to my Dr of 25yrs, I go to my Annual Wellness visit, supposedly free. Right off the bat I was greeted with a $300 charge upfront. I thought weird, but I’ll get reimbursed. I was wrong. My Dr said they just don’t make any money off the wellness visit and have to charge extra. I was/am pissed. I wish the government and even my Dr not say that it was free. $300 extra, on top my Medicare premiums I would consider a heavy charge for such little work. They get the Medicare reimbursement plus my$300. I’d call it a rip.

This is a fantastic video. It's clear and easy to understand your explanations. Thank you for providing this information.

So I had a Medicare advantage plan that I went to. Turns out there said I can only go to in network drs or I would have to pay for it. That was fine but when it came down that no one in my area was in the network and had to travel 50 or more miles to go to a in network Dr. Heck no. I got rid of that plan quick. Do not do a Medicare advantage plan you won't like it.

Vision: Rather than buying a separate vision plan, consider self-pay. Many places offer exams for around $40 - some free if you buyu glasses through them. Once you get the exam, take the prescription and go on-line to one of the many places that offer glasses for less. There are many options; personally I use Zenni optical. If you're not sure how to do it, you can call and they will walk you through it. Instead of paying hundreds of dollars for glasses, you can often get them for less than $100.

(At 6:34) During a routine examination,the Doctor discovered that my husband had A fibrillation and put him on a blood thinner. When he saw the cardiologist for an echo cardio gram,he said “good for you that your doctor listened to your heart, A fibrillation is usually discovered after the person has had a stroke!”😬

You are a wealth of information .Thx.

Great information. Thank you

Thanks as always. We have found that vision exams are covered under part B IF you are a diabetic. It’s a much more in-depth examination. PS, loved the kids video at the end!

Be very wary about Long Term Care insurance plans. Even an independent insurance agent who sold various types of insurance pointed out that a significant amount of time (months) must pass before their coverage even starts paying out. The cost is so high and the coverage so meager that many found it made more sense to refrain from buying it.