Original Medicare pays for a wide range of hospital and medical care, but it leaves several everyday health costs entirely uncovered. Routine dental work, eyeglasses, hearing aids, and long-term custodial care are among the biggest gaps. Here’s the partial list of what Medicare doesn’t cover in 2026, what you’ll pay out of pocket for each one, and where additional coverage like Medigap or Medicare Advantage can help.
Routine Dental Care
In most cases, Medicare doesn’t cover routine dental services like cleanings, fillings, tooth extractions, dentures, or implants. You pay the full cost yourself. Source: Medicare.gov.
The one exception is dental care tied directly to a covered medical treatment, such as an oral exam before a heart valve replacement or organ transplant, or treating a mouth infection before cancer treatment. In those specific cases, Part B covers 20% coinsurance after your deductible.
While it doesn’t fall under the “routine dental care” category, please be sure that medically necessary oral surgery is also covered at 80% after deductibles under medicare.
Routine Vision Care and Glasses
Medicare doesn’t cover routine eye exams for glasses or contact lenses, and it doesn’t pay for eyeglasses or contacts in most situations. Source: Medicare.gov.
The exception: after cataract surgery that implants an intraocular lens, Part B covers one pair of standard eyeglasses or one set of contact lenses. You’d still pay 20% coinsurance after your Part B deductible, plus any cost for upgraded frames.
Hearing Aids
Original Medicare covers diagnostic hearing and balance exams your doctor orders, but it doesn’t cover hearing aids or the exams to fit them. That leaves hearing aids as a full out-of-pocket purchase for most Medicare beneficiaries. Source: Medicare.gov.
Some Medicare Advantage plans and Medigap plans with Extra Benefits in certain states advertise hearing, vision, and even dental benefits as extras. Coverage amounts and networks vary widely by plan and area, so check the specifics before assuming a plan covers what you need.
Long-Term Custodial Care
Medicare draws a hard line between skilled care and custodial care, and it’s one of the most expensive gaps on this list. Part A covers a skilled nursing facility (SNF) stay only after a qualifying 3-day inpatient hospital stay, and only when you need daily skilled nursing or therapy. After the $1,736 deductible, days 1-20 cost $0, days 21-100 cost $217 per day, and everything past day 100 is on you. Source: Medicare.gov.
Custodial care (help with bathing, dressing, eating, and other daily activities that doesn’t require a skilled nurse or therapist) isn’t covered at all, no matter how long you need it. Most nursing home stays fall into this category. Medicaid, long-term care insurance, and personal savings are the main ways people cover it, and planning for that gap is outside what our team at Senior65 helps with directly.
Care You Get Outside the U.S.
Original Medicare generally doesn’t pay for care you receive outside the United States. There are a few narrow exceptions, like a medical emergency where a Canadian hospital is closer than the nearest U.S. hospital, but they cover very specific situations, not travel generally.
💡 Tip: This is why many Medigap policies include a foreign travel emergency benefit as a built-in add-on. If you travel internationally, it’s worth checking whether your plan includes it before you go. Get a Medigap quote to compare plans that include this benefit.
Cosmetic Surgery and a Few Other Exclusions
A handful of smaller exclusions round out the list. Medicare doesn’t cover cosmetic surgery unless it’s needed to repair an accidental injury or fix a malformed body part. Routine foot care (trimming nails, treating calluses) isn’t covered either, except for people with diabetes-related nerve damage. Acupuncture is covered only for chronic low back pain, up to a set number of sessions, and isn’t covered for any other condition.
The Costs Medicare Does Cover, But Leaves You to Pay
It’s worth separating what Medicare excludes entirely from what it covers but still bills you for.
Part A carries a $1,736 deductible per benefit period, and hospital stays get expensive fast after day 60 ($434 per day for days 61-90, $868 per day after that).
Part B has its own $283 deductible, a $202.90 monthly premium, and an ongoing 20% coinsurance on most services with no annual out-of-pocket cap.
This is where a Medicare Supplement policy (also called Medigap) comes in. Medigap picks up most or all of the deductibles and coinsurance for services Original Medicare passes on to you, For example Medigap plan G would cover the 20% of doctor and hosptial fees passed on to you in additional to the Part A deductible. It would also cover 100% of the covered hospital bill portion that Medicare passes on to you (including 365 extra days of hospital coverage after Medicare stops paying.)
A Medigap plan doesn’t typically offer coverage for the excluded items above (dental, vision, hearing aids, or custodial care).
Learn how Medigap underwriting works if you’re considering a plan outside your Medigap Open Enrollment window.
Senior65 also offers separate vision, dental, and hearing add-on plans for people who want coverage for the items Original Medicare and Medigap both leave out.
How to Cover These Gaps
Most people end up combining a few pieces: Original Medicare for hospital and medical care, a Medigap policy for the deductibles and coinsurance Medicare leaves behind, and a separate dental, vision, or hearing plan for the routine care Medicare never covers. If you’re weighing Medigap against a Medicare Advantage plan that bundles in some of these extras, compare the actual benefit amounts and networks, not just the fact that a benefit exists.
We receive commissions directly from insurance companies, and by law our prices are the guaranteed lowest you’ll find, whether you compare plans yourself or call our team at Senior65.com. If you’d like help sorting through your options, start with an overview of Medicare or reach out to our team directly.