What Medicare Does Not Cover in 2026
Last reviewed: June 2026 · Reviewed by Galit Sacajiu MD, MPH
Medicare covers a lot, but it was never designed to cover everything. The gaps are real and, in some cases, expensive. People are often surprised to learn that routine dental work, eyeglasses, hearing aids, and most long-term care are simply not covered by Original Medicare.
This page covers the most significant gaps in Medicare coverage and explains what your options are for each one.
The Biggest Medicare Coverage Gaps
Routine Dental Care
Original Medicare does not cover routine dental exams, cleanings, fillings, extractions, crowns, bridges, dentures, or implants. The only dental care Medicare Part A covers is treatment required as part of a covered inpatient hospital stay — for example, jaw surgery after a medically necessary procedure.
Your options
Medicare Advantage plans frequently include dental benefits, though coverage varies widely by plan. Standalone dental plans are available from private insurers at an additional cost.
Vision Care and Eyeglasses
Medicare does not cover routine eye exams for glasses or contact lenses. It does not pay for eyeglasses or contacts either. Part B covers a dilated eye exam for diabetic retinopathy once a year and certain surgical procedures for conditions like cataracts or glaucoma, but that is the extent of it.
Your options
Many Medicare Advantage plans include a vision benefit with an annual allowance for exams and frames. Discount programs like VSP or EyeMed are alternatives outside of Medicare.
Hearing Aids
Original Medicare does not cover hearing aids or routine hearing exams to fit them. Hearing aids can cost $1,000 to $6,000 per pair or more, making this one of the most financially significant Medicare gaps for many seniors.
Your options
Some Medicare Advantage plans include a hearing benefit with an annual allowance toward hearing aids. Over-the-counter hearing aids approved by the FDA in 2022 offer a lower-cost alternative for mild to moderate hearing loss.
Long-Term Custodial Care
This is the gap that catches people most off guard. Medicare does not cover custodial care — help with daily activities like bathing, dressing, eating, or moving around — whether provided in a nursing home or at home. Part A covers short-term skilled nursing care after a hospital stay, but once skilled care is no longer needed, Medicare stops paying.
Your options
Long-term care insurance is the primary private option, though premiums are highest when purchased after age 65. Medicaid covers long-term care for people with limited income and assets. Some life insurance policies now include long-term care riders.
Prescription Drugs (Without Part D)
Original Medicare (Parts A and B) does not cover most prescription drugs taken at home. Part A covers some drugs administered during an inpatient hospital stay, and Part B covers a specific list of drugs administered in a clinical setting (like chemotherapy or dialysis medications). But for drugs you pick up at a pharmacy, you need Part D.
Your options
Enroll in a standalone Part D Prescription Drug Plan or choose a Medicare Advantage plan that includes drug coverage (MAPD). If you skip Part D and later enroll, you will owe a permanent late enrollment penalty.
Care Outside the United States
Medicare generally does not cover medical care received outside the United States. There are very narrow exceptions — care on a ship within U.S. territorial waters, or emergency care when a foreign hospital is closer than the nearest U.S. facility — but these are rare situations.
Your options
Medigap Plans C, D, G, M, and N include a foreign travel emergency benefit that covers 80% of emergency costs abroad after a $250 deductible, up to a $50,000 lifetime limit. Travel health insurance is another option for international coverage.
Cosmetic Surgery
Medicare does not cover cosmetic surgery or any procedure performed solely to improve appearance. If a procedure has both cosmetic and medically necessary components — such as reconstructive surgery after an accident or mastectomy — Medicare may cover the medically necessary portion.
Your options
Medically necessary reconstructive procedures are generally covered under Part B. If you are unsure whether a procedure qualifies, ask your doctor to document the medical necessity before proceeding.
Acupuncture (With Exceptions)
Medicare covers acupuncture only for chronic low back pain under a specific Part B benefit added in 2020 — up to 20 sessions per year for qualifying patients. All other acupuncture treatments are not covered.
Your options
For acupuncture beyond what Medicare covers, patients pay out of pocket. Some Medicare Advantage plans include supplemental benefits for acupuncture.
Cost Gaps in What Medicare Does Cover
Beyond the excluded services, Original Medicare leaves you responsible for a significant share of costs even for covered services. There is no annual out-of-pocket maximum in Original Medicare, so a serious illness or long hospital stay can expose you to tens of thousands of dollars in costs.
| Gap | What You Owe (2026) |
|---|---|
| Part A deductible | $1,736 per benefit period (not per year) |
| Hospital days 61-90 | $433 per day |
| Lifetime reserve days (91+) | $866 per day |
| Part B deductible | $283 per year |
| Part B coinsurance | 20% of all covered outpatient costs — no cap |
| Skilled nursing days 21-100 | $216.50 per day |
| Skilled nursing after day 100 | 100% of costs — no coverage |
The 20% Problem
After meeting the $283 Part B deductible, you owe 20% of all Medicare-approved costs for covered services with no annual cap. A $200,000 cancer treatment course means $40,000 out of your pocket. A Medigap Plan G or Medicare Advantage plan with a set out-of-pocket maximum eliminates this exposure.
How to Fill the Gaps
Medicare Advantage (Part C)
Replaces Original Medicare. Plans often include dental, vision, and hearing benefits, and set an annual out-of-pocket maximum that caps your spending. Most plans include drug coverage.
Compare Advantage plans →Medicare Supplement (Medigap)
Works alongside Original Medicare to cover the cost-sharing gaps — deductibles, coinsurance, and hospital stays. Does not cover dental, vision, or hearing, but eliminates most out-of-pocket cost risk.
Compare Medigap plans →Part D Drug Plan
Covers prescription drugs taken at home. Required separately if you have Original Medicare. Included in most Medicare Advantage plans.
Learn about Part D →Long-Term Care Insurance
Private insurance that covers custodial care in a nursing home or at home. Best purchased before age 65 when premiums are lower. Covers what Medicare and most health plans do not.
Medicare basics overview →Frequently Asked Questions
Does Medicare cover dental implants?+
No. Original Medicare does not cover dental implants, dentures, crowns, fillings, or any routine dental work. Some Medicare Advantage plans include dental benefits, and some of those plans cover implants or major restorative work, though limits and waiting periods apply. Check the dental benefit details in any Advantage plan before enrolling.
Does Medicare pay for a hearing aid?+
Original Medicare does not cover hearing aids or the fitting exams for them. Many Medicare Advantage plans now include hearing benefits, typically offering an annual allowance of $500 to $2,500 toward hearing aids from in-network providers. Over-the-counter hearing aids became available without a prescription in 2022 and offer a lower-cost option for mild to moderate hearing loss.
Does Medicare cover nursing home care?+
Medicare covers short-term skilled nursing facility care after a qualifying 3-day hospital stay, but only up to 100 days. After day 100, Medicare pays nothing. Medicare does not cover custodial nursing home care — help with bathing, dressing, eating, and other daily activities — at any point. Medicaid covers long-term nursing home care for eligible low-income beneficiaries. Long-term care insurance covers it for others.
Will Medicare cover me if I get sick abroad?+
Generally no. Medicare does not cover medical care received outside the United States. There are narrow exceptions for emergency care near a U.S. border or on a ship in U.S. waters. If you travel internationally, Medigap Plans C, D, G, M, and N include a foreign travel emergency benefit covering 80% of emergency costs up to $50,000 lifetime. Travel insurance with medical coverage is another option.
Does Medicare cover eye exams and glasses?+
Medicare Part B does not cover routine eye exams for glasses or the cost of glasses or contact lenses. It does cover diagnostic and treatment-related eye care, including dilated eye exams for diabetic retinopathy, cataract surgery, and treatment for glaucoma. After cataract surgery, Medicare covers one pair of standard eyeglasses or contacts. Many Medicare Advantage plans include a vision benefit for routine exams and frames.