Retirement Healthcare Expenses That Medicare Does Not Cover

Most people become eligible to sign up for Medicare three months before they turn 65. While Medicare is a safety net, it does not cover everything. Understanding there are gaps in coverage and being aware of them early can help you plan and avoid unexpected healthcare expenses in retirement. If you are not prepared for these expenses, they can exhaust your retirement savings. Knowing what Medicare does not cover allows you to plan ahead and consider supplemental insurance.

What retirement healthcare expenses are not covered by Medicare?

1. Outpatient prescription drugs

Prescription drugs are a critical part of healthcare, especially as you age, but Original Medicare does not automatically cover outpatient prescription medications. If you rely only on Medicare Part A and B, you could be paying out of pocket for the medicines you need.

But you can consider purchasing Medicare Part D to cover prescription drugs. Alternatively, you could opt for a Medicare Advantage plan, which bundles medical care and prescription coverage into one policy. You can enroll in a Part D plan or a Medicare Advantage plan when you first sign up for Medicare. If you miss this window, you may have to wait until the annual open enrollment period in the fall to make changes.

In 2025, if you enroll in a Part D or Medicare Advantage plan that includes prescription coverage, your out-of-pocket costs for medications will be limited to $2,000 for the year. In 2026, that cap increases slightly to $2,100, so planning ahead is important. For those enrolled in the Medicare Prescription Payment Program (MPPP), coverage is typically renewed automatically each year unless you withdraw from it.

2. Dental care

Dental problems tend to increase with age, and preventive care can save you a lot of stress, pain, and money down the line. However, unfortunately, dental care is one of the biggest gaps in traditional Medicare coverage. Medicare Parts A and B generally do not cover routine dental care. This includes exams, cleanings, fillings, crowns, bridges, or dentures.

Medicare will only step in for dental work if it is directly related to another covered medical procedure. For example, if you require jaw surgery and a dentist is involved as part of that procedure, Medicare may cover some of the costs. But outside of those very specific circumstances, you are pretty much on your own. And dental work is not cheap. A single dental implant can typically cost you anywhere from $1500 to $2000. If you are facing multiple procedures, the bills can add up quickly. Because of these costs, you may want to consider supplemental coverage through dental insurance to help manage your healthcare expenses in retirement. These plans may cover preventive care, crowns, bridges, and more.

3. Vision care

Vision care is another area where Medicare leaves a noticeable gap. Traditional Medicare, which includes Parts A and B, does not cover routine eye exams, prescription eyeglasses, or contact lenses. Medicare does step in for certain eye conditions that are considered medically necessary. For example, if you need cataract surgery or if you have diabetes. In these cases, Medicare may cover your annual cataract or diabetic eye exams. But outside of these specific situations, routine vision care is entirely your responsibility. Considering the rising costs of prescription eyeglasses, contact lenses, and other eye equipment, it is important to plan ahead.

You may use Medicare Advantage plans, also known as Part C plans. These are private insurance plans that combine traditional Medicare coverage with extra benefits, often including routine vision care.

4. Long-term care

According to Genworth estimates cited by SeniorLiving.org, the median cost of a private room in a nursing home in 2025 is around $131,583 per year. That is a hefty sum, and the reality is that Medicare will not cover most of it.

Medicare does cover certain skilled nursing services, such as short-term stays right after a surgery or illness. However, it does not cover ongoing assistance you may need with basic daily activities, such as bathing, dressing, eating, or moving around. So, if you need support in an assisted living facility, the costs will fall squarely on your shoulders. Medicare simply is not designed to fund extended long-term care. Because these costs can quickly drain your savings, one option you can consider is long-term care insurance, which can cover expenses in a nursing home, assisted living facility, or even in your own home.

You can also set aside a dedicated long-term care fund within your overall retirement plan. However, this could require discipline and saving consistently. Buying long-term care insurance can be relatively simpler and also more cost-effective. No matter what you choose, keep in mind that the average healthcare expenses in retirement, especially for long-term care, will likely rise. So, it is essential to ensure you have sufficient financial resources to cover these expenses.

5. Hearing aids

Did you know that in 2025, a single hearing aid can range from $1,500 to $4,150, which means a pair could cost anywhere between $3,000 and $8,300? Surprised? And that is just the price in 2025.

If you retire in ten years and end up needing hearing aids another ten years after that, you also have to consider inflation. These costs could be significantly higher by then. But hearing aids may be essential for maintaining your quality of life as you age. And you certainly cannot ignore them or live without them if they have been prescribed to you.

Traditional Medicare does not cover hearing exams, nor does it cover the devices themselves. So, this is an expense that would come out of your pocket sometime down the line. Some Medicare Advantage plans may offer limited coverage for hearing aids and provide partial reimbursement for exams. You may even qualify for discounts on devices, but coverage varies widely from plan to plan. That is why it is important to carefully compare your options before enrolling. If you choose the right plan, you can reduce your healthcare expenses in retirement and make hearing aids more affordable when you need them.

6. Deductibles and co-pays

Have you ever thought about how much you will actually pay out of pocket under Medicare? It is not just about premiums but also deductibles and co-pays. Medicare Part A, which covers hospital stays, comes with a deductible that you will need to meet before coverage starts. In 2025, that deductible is $1,676. On top of that, if you have an extended hospital stay, you will be responsible for $419 per day for days 61 through 90, and $838 per day after that. Medicare also provides 60 lifetime reserve days beyond the 90-day limit, but once those are used up, you are on the hook for the full cost of any additional hospital days.

If you have Medicare Part B, it will cover 80% of the costs, but the remaining 20% after a $257 deductible in 2025 will be on you. If you want to avoid these gaps, you can opt for a Medigap policy or Medicare Supplement plan. These policies are sold by private insurers and come in 10 standardized versions. And if you buy a Medigap policy within six months of enrolling in Part B, insurers cannot deny you coverage or charge you more because of preexisting conditions.

7. Overseas medical care

Have you thought about what happens if you need medical care while traveling abroad? Medicare will not cover you outside the United States, except in very limited circumstances. If you plan to spend part of the year in another country, such as for a summer retreat, a winter getaway, or just an extended vacation, you will need to plan ahead.

If you do plan to be abroad in retirement, you would need supplemental options. One choice is to purchase travel medical insurance, which can cover unexpected medical emergencies while you are abroad. Another option is to look into Medigap plans that specifically include foreign emergency coverage.

8. Alternative therapies

Did you know that Medicare generally does not cover alternative therapies? Services such as acupuncture, chiropractic care, or naturopathic medicine typically fall outside traditional Medicare coverage. While some people swear by these treatments for overall wellness, you will need to pay out of pocket if you want to use them.

Some Medicare Advantage plans might offer limited coverage for certain alternative therapies, but there are usually restrictions on the types of treatments covered. So, it is important to budget for them separately.

9. Routine foot care

Routine foot care is not typically covered by Medicare. Simple tasks, such as removing corns or calluses and trimming nails, are generally considered self-care. Medicare assumes you or a caregiver can handle these without needing the skills of a physician or other qualified healthcare professional.

However, there are exceptions if you have certain medical conditions that put your feet at risk. For example, patients with diabetes mellitus may need professional foot care because nerve damage or poor circulation can make routine care risky. Peripheral vascular disease is another qualifying condition. Peripheral neuropathy and chronic kidney disease with complications can also make medically necessary foot care eligible for coverage.

In these cases, Medicare may cover foot care performed by a healthcare professional if it is needed to prevent complications. The key is that the care must be tied to a diagnosed medical condition that makes routine self-care unsafe or inadequate. Essentially, Medicare covers what is medically necessary, but routine foot maintenance is up to you, and hence should be covered by you.

10. Cosmetic surgery

Did you know that Medicare generally does not cover cosmetic surgery? If your goal is purely aesthetic, like getting a facelift, Botox, or a tummy tuck, you will need to pay out of pocket. Medicare considers these procedures not medically necessary, so they are not covered under standard Medicare benefits.

However, Medicare will step in if surgery is needed for medical reasons. For example, reconstructive procedures after an accident, congenital abnormalities, or surgeries to restore function due to illness or injury are typically covered. If you require breast reconstruction after a mastectomy or reconstructive surgery following the removal of skin cancers like melanoma, Medicare may cover the procedure.

Original Medicare splits the coverage between Part B and Part A. If the procedure is necessary to restore function or repair damage, you are generally covered. If it is just for improving your appearance, you are on your own financially.

Because healthcare isn’t fully covered

Understanding what Medicare does not cover is important. There are several items on the list, so reviewing them carefully is a must. You can make a checklist and mark the ones that could apply to you. For example, if you wear glasses, you will likely have ongoing vision-related expenses in retirement. Make sure these are either covered by your health insurance or budgeted for appropriately.

If you are wondering how you can plan for healthcare expenses in retirement, working with a financial advisor can be a big help. Our free advisor match tool can help you hire someone near you in a few simple clicks and clacks.