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What Costs Does Medicare Not Cover In 2025? Here’s What Retirees Need To Know

Joel Ryan by Joel Ryan
May 8, 2025
in Social Security
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What Costs Does Medicare Not Cover In 2025? Here’s What Retirees Need To Know

For millions of older Americans, turning 65 and becoming eligible for Medicare is a milestone that brings a sense of security. After decades of paying into the system, many retirees believe Medicare will cover most of their healthcare needs during retirement.

However, while Medicare offers essential coverage for hospital stays, doctor visits, and preventive services, it does not cover everything. Without careful planning, retirees may face steep, unexpected medical bills that can strain even the best-prepared retirement savings.

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This article explores what Medicare doesn’t cover in 2025 — and the steps you can take to protect yourself financially.

What Traditional Medicare Doesn’t Cover

While Medicare Parts A and B cover a wide range of medical services, there are notable exclusions that retirees should be aware of.

Dental Care

Medicare does not cover routine dental services such as cleanings, fillings, crowns, dentures, or implants unless they are part of a covered medical procedure (like jaw surgery). Considering that a single dental crown can cost between $800 and $2,500, lacking dental coverage can lead to significant out-of-pocket expenses.

Vision Care

Routine vision services — including eye exams, prescription glasses, and contact lenses — are not covered by traditional Medicare. Coverage applies only when related to specific medical conditions, such as cataract surgery or diabetic eye disease. With age-related vision changes, these costs can add up over time.

Hearing Aids

Medicare also does not cover hearing aids or the exams required to fit them. With prices ranging from $2,000 to $7,000 per pair, untreated hearing loss can become both a health and financial burden.

Prescription Medications

Unless you enroll in a Medicare Part D plan or choose a Medicare Advantage plan that includes drug coverage, you’ll be responsible for prescription drug costs. Thankfully, under a new rule in 2025, out-of-pocket spending for Part D enrollees is capped at $2,000 per year — but you must have the coverage in place to benefit.

Long-Term Care

Medicare only covers short-term skilled nursing after a qualifying hospital stay. It does not pay for long-term custodial care, such as assistance with bathing, eating, or living in a nursing home. With private nursing home costs now averaging over $120,000 per year, this is one of the most financially threatening gaps for retirees.

Medical Care Abroad

For retirees who plan to travel internationally, it’s important to know that Medicare generally does not cover care received overseas, except in very limited situations. Without additional coverage, retirees are responsible for any medical costs incurred while traveling.

How to Protect Yourself from Medicare’s Coverage Gaps

Recognizing where Medicare coverage ends is the first step. The next — and most crucial — step is taking action to manage these risks.

Consider a Medigap Plan

Medigap, or Medicare Supplement Insurance, helps cover out-of-pocket costs like deductibles, copayments, and coinsurance. If you enroll within six months of signing up for Medicare Part B, you have guaranteed acceptance without higher premiums due to pre-existing conditions.

Explore Medicare Advantage Plans

Medicare Advantage plans, offered by private insurers, often include extra benefits such as dental, vision, and hearing coverage. However, not all plans are equal. Research carefully, as some plans have been known to deny claims unfairly, and be ready to appeal if necessary.

Use Health Savings Account (HSA) Funds

Although you can’t contribute to an HSA once you’re on Medicare, any funds saved beforehand can be used tax-free for qualified medical expenses — including dental, vision, and hearing costs — in retirement.

Look into Long-Term Care Insurance

Long-term care insurance or hybrid life insurance policies with long-term care riders can help cover costs associated with chronic illness care, assisted living, or nursing home stays. These policies can provide essential protection for those worried about extended care needs.

Purchase Travel Medical Insurance

If you plan to travel abroad, consider travel medical insurance or a Medigap policy with international emergency coverage. This will ensure you’re protected if you need urgent care outside the U.S.

The Bottom Line

Medicare is an essential safety net for retirees — but it’s not a complete solution. Understanding what Medicare won’t cover in 2025 allows you to plan ahead and avoid unpleasant financial surprises.

By supplementing Medicare with additional insurance, using savings strategies like HSAs, and proactively preparing for long-term care needs, you can safeguard your health and your finances. The better informed you are now, the more confident and secure you’ll feel throughout retirement.

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