Services Not Covered by Medicare Part B

When you look at the list of what Medicare Part B doesn't cover, plus the deductibles and copays you have to pay for Part B, it's easy to understand why some people with traditional Medicare wind up personally responsible for almost half of their medical bills. (To see a list of the services that Medicare Part B does cover, see our article on what Medicare Part B covers.)

Below we'll discuss the categories of medical treatment and services listed below not covered by Medicare Part B. But the non-covered services discussed below don't necessarily apply to Medicare Advantage plan coverage. Many Medicare Advantage plans include some coverage for these medical services, plus supplemental coverage in other areas, even though traditional Medicare Part B doesn't cover them.

What Does Medicare Part B Not Cover?

Medicare Part B typically doesn't cover routine vision, hearing, and dental care, regular foot care, and aids like eyeglasses, contact lenses, and hearing aids. But Part B policies often change, so it's important to verify coverage details with Medicare. Here are the most common medical expenses that aren't currently covered by Part B.

Treatment That's Not Medically Necessary

Medicare won't pay for medical care that the Centers for Medicare and Medicaid Services (CMS) doesn't consider medically necessary. This includes most elective and cosmetic surgeries, plus virtually all alternative forms of medical care such as acupuncture, acupressure, and homeopathy—with the one exception of the limited use of chiropractors. (Part B will cover chiropractic services only for the manual manipulation of the spine to correct a vertebral subluxation.)

Vaccinations and Immunizations

Medicare Part B will cover vaccines for the flu, COVID-19, pneumonia, and hepatitis B. Medicare doesn't cover most other vaccinations and immunizations—such as those taken before travel abroad. There's one exception for emergencies in which, for example, vaccinations or immunizations are required because of the risk of infection or because of exposure to a communicable disease.

Prescription Drugs You Take at Home

Generally, Part B medical insurance covers only drugs that can't be self-administered and that you receive as an outpatient at a hospital, a clinic, or at the doctor's office. But there are some exceptions, such as self-administered insulin and some types of chemotherapy.

You can sign up for a Medicare Part D plan (or a Medicare Advantage plan with drug coverage) to cover most other medications you take at home. And Medicare Part A covers drugs administered while you're in the hospital or in a skilled nursing facility.

Nonprescription Drugs

Medicare Part B doesn't cover any of the cost of over-the-counter medicines, vitamins, or supplements, regardless of whether they provide help with a medical condition, even if they've been recommended by a doctor.

Eyesight and Hearing Exams, Glasses, and Hearing Aids

Medicare medical insurance doesn't cover routine eye exams ("refractions"). Neither does it cover eyeglasses or contact lenses, except for lenses required following cataract surgery. However, if your eyes are affected by an illness or injury other than simple loss of strength, the examination and treatment by an ophthalmologist—an eye doctor who is an M.D.—or other physician is covered. Part B will also cover glaucoma and diabetic retinopathy screenings once a year for people at high risk of those diseases.

Medicare Part B generally doesn't cover routine hearing examinations or hearing aids, but some visits to the audiologist may be covered, particularly if you have surgically implanted hearing devices. And Part B will cover implants that replace the middle ear function if hearing aids are medically inappropriate.

Dental Work

Medicare won't cover dental treatment unless the problem is unrelated to normal tooth decay or gum disease and involves either the blood vessels, nerves, or the bones of the mouth or jaw. In other words, if the treatment is considered medical rather than dental, Medicare may cover it. Generally, Medicare doesn't cover work performed by a dentist or oral surgeon who isn't an M.D., unless the same work would be covered if performed by a physician.

Long-Term Care

While Medicare Part B covers some home health care (see our article on Medicare coverage of home health care), that care is only part-time or intermittent and is for the homebound. Medicare doesn't provide the kind of long-term care, either at home or in a facility, that many older people need because of frailty or the inability to perform the activities of daily living without help. Medicaid, however, does cover long-term care; see our article on Medicaid's coverage of nursing home and assisted living facilities.

Supplementing Part B Medical Insurance

Part B Medicare medical insurance is intended to pay for only a portion of doctor bills, outpatient hospital and clinic charges, laboratory work, physical and speech therapy, medical supplies, some home health care, and a very few drugs. Many people fill in the gaps in Medicare by joining a Medicare Advantage health plan (called Medicare Part C). A Medicare Advantage plan often comes in the form of a managed care plan and combines basic Medicare-level coverage with supplemental benefits. Alternatively, private Medicare supplement insurance—called medigap insurance—can help you make up the difference, but it can be expensive.

For more information on Medicare Part C and medigap plans, see our article on Medicare Advantage plans.