What Medicare won’t pay for in 2026

Dear Savvy Senior,

To avoid any future health care surprises, can you tell me what original Medicare doesn’t cover in 2026?

New Beneficiary

Dear Beneficiary,

It's a great question. While original Medicare (Part A and B) covers a wide array of health care services after you turn 65, it doesn’t cover everything.

If you need or want certain services that aren’t covered, you’ll have to pay for them yourself unless you have other insurance or you enroll in a Medicare Advantage health plan, which may provide some additional benefits.

Here’s a look at some commonly needed medical services original Medicare doesn’t pick up the tab for:

—Most dental care: Routine dental care including checkups, cleanings, x-rays, fillings, root canals, tooth extractions and dentures are not covered by original Medicare.

—Routine vision care: Medicare does not cover routine eye exams, eyeglasses and contact lenses, except following cataract surgery, but tests, treatments and surgeries for medical eye diseases like cataracts, glaucoma and macular degeneration are covered.

—Hearing aids: Original Medicare will not pay for hearing exams or hearing aids but may cover a hearing and balance exam if your doctor determines it’s necessary.

—Prescription drugs: Medicare (Part A and B) doesn’t provide coverage for outpatient prescription drugs, but you can buy a separate Part D prescription-drug policy that does.

—Alternative medicine: Acupuncture (except to treat low back pain), chiropractic services (except to correct a vertebral subluxation of the spine) and other types of alternative or complementary care are not covered by Medicare.

—Cosmetic surgery: Most cosmetic procedures are not covered; however, if the surgery is due to an injury or deformity, it might pay. For example, Medicare will cover a breast prosthesis for breast cancer survivors.

—Foot care: Medicare does not cover most routine foot care, like the cutting or removing of corns, calluses and toenails. But they do cover medically necessary podiatrist services for foot problems like hammertoes, bunion and heel spurs, along with exams, treatments and therapeutic shoes or inserts if you have diabetic foot problems.

—Long-term care: Nursing home care and assisted living facilities are not covered by Medicare. But Medicare will help pay up to 100 days of skilled nursing or rehabilitation care immediately following a hospital stay of three or more days.

—Personal home care: If you need to hire help for bathing, dressing or getting out of bed, Medicare typically won’t cover these costs either, unless you are homebound and also are receiving skilled nursing care. Housekeeping services such as shopping, meal preparation and cleaning are not covered either unless you are receiving hospice care.

—Adult diapers: Medicare does not cover the cost of adult diapers or other incontinence supplies. These items are considered to be for personal hygiene rather than medical treatment.

—Overseas coverage: In most cases health care outside the United States is not covered by Medicare, except for very limited circumstances such as on a cruise ship within six hours of a U.S. port.

The best way to find out what original Medicare covers is to talk to your health care provider; visit www.Medicare.gov/coverage and type in your test, item or service; or download the Medicare “What’s covered” app on the App Store or Google Play.

Also keep in mind that even if Medicare covers a service or item, they don’t pay 100% of the cost. You will have to pay a monthly Part B premium, which is $202.90 for most beneficiaries in 2026, and unless you have supplemental insurance, you’ll have to pay your annual deductibles and copayments too. However, most preventive services are covered 100% by Medicare with no copays or deductibles.

Send your questions or comments to questions@savvysenior.org or to Savvy Senior, P.O. Box 5443, Norman, OK 73070.