What procedure is not covered by Medicare?

Cosmetic surgery is a procedure generally not covered by Medicare Parts A and B.

Understanding Medicare's Coverage Limitations

While Medicare provides essential health coverage for millions of Americans, it's important to understand that not all medical services or procedures are included. Original Medicare (Parts A and B) primarily covers medically necessary inpatient and outpatient services. Many services considered routine, elective, or non-essential for treating illness or injury are typically excluded from coverage.

Key Services Not Covered by Medicare Parts A and B

Several categories of services and specific procedures fall outside the scope of standard Medicare coverage. These exclusions are in place to prioritize medically necessary care.

Here are some of the most common procedures and services generally not covered:

• Cosmetic Surgery: Procedures performed solely to improve appearance, such as facelifts, liposuction, or breast augmentation, are typically not covered. Medicare will only cover cosmetic surgery if it's necessary to repair an accidental injury or improve the function of a malformed body part.
• Routine Physical Exams: While Medicare covers annual wellness visits, it generally does not cover routine physical exams that most people associate with a comprehensive check-up, including specific tests not covered by the wellness visit.
• Most Vision Services: This includes routine eye exams for prescribing glasses or contact lenses. Coverage is usually limited to eye diseases or injuries that require medical treatment.
• Most Dental Services: Routine dental care such as cleanings, fillings, tooth extractions, dentures, and dental plates are typically not covered.
• Most Hearing Services: This includes hearing aids and routine exams for fitting hearing aids.

Summary of Non-Covered Procedures

To provide a clearer overview, here's a table summarizing common procedures and services generally excluded from Medicare Parts A and B coverage:

It's crucial for beneficiaries to be aware of these exclusions to avoid unexpected out-of-pocket costs. For coverage of some of these excluded services, individuals often consider Medicare Advantage Plans (Part C) or separate insurance plans.