Medicare Basics

What Medicare Doesn't Cover (and How to Fill the Gaps)

Austin TylerLocal Kentucky Medicare agent · June 9, 2026 · 6 min read

People are often surprised by what isn't in Original Medicare. Knowing the gaps ahead of time lets you plan for them instead of getting a shocking bill. Here's what Original Medicare (Parts A and B) generally does not cover — and how to handle each one.

Routine dental, vision, and hearing

Original Medicare doesn't cover routine dental (cleanings, fillings, dentures), routine eye exams or glasses, or hearing exams and hearing aids. How to fill it: many Medicare Advantage plans bundle in dental, vision, and hearing benefits, or you can buy standalone dental and vision coverage.

Long-term care (the biggest gap)

This is the one that catches families off guard. Medicare does not pay for long-term custodial care — ongoing help with daily activities like bathing, dressing, or eating, whether at home or in a nursing home. Medicare only covers short-term, skilled care, like rehab after a hospital stay. How to fill it: long-term care insurance, personal savings, or Medicaid for those who qualify.

Most care outside the United States

Original Medicare generally won't cover care when you travel abroad. How to fill it: some Medigap plans include limited foreign-travel emergency coverage, and travel medical insurance can cover the rest.

Prescription drugs aren't in Parts A & B

Original Medicare by itself doesn't cover most outpatient prescriptions — that's the job of Part D (standalone, or built into a Medicare Advantage plan). Skipping drug coverage when you're first eligible can cost you a lifelong penalty. More in Medicare Made Simple.

Cosmetic procedures and a few others

Cosmetic surgery, most routine foot care, and acupuncture or chiropractic beyond limited situations are generally not covered.

The 20% with no cap is its own "gap."Even for things Medicare does cover, Original Medicare alone leaves you paying about 20% with no yearly limit. That's why people add a Medigap plan or choose Medicare Advantage, which includes an out-of-pocket maximum.

Common questions

Does Medicare cover dental and vision?

Original Medicare doesn't cover routine dental or vision. Many Medicare Advantage plans add those benefits, or you can buy standalone dental and vision coverage.

Does Medicare pay for a nursing home?

Medicare only covers short-term skilled care, such as rehab after a hospital stay — not long-term custodial care. Long-term care is paid through long-term care insurance, savings, or Medicaid for those who qualify.

Does Medicare cover prescription drugs?

Not under Parts A and B. You get drug coverage through Part D, either as a standalone plan or built into a Medicare Advantage plan.

Does Medicare work when I travel abroad?

Original Medicare generally doesn't cover care outside the U.S. Some Medigap plans add limited foreign-travel emergency coverage.

Quick recap

Original Medicare doesn't cover routine dental, vision, or hearing — Advantage plans or standalone policies can.

The biggest gap is long-term custodial care; Medicare only covers short-term skilled care.

Most care outside the U.S. isn't covered; some Medigap plans add limited travel coverage.

Prescriptions come from Part D, not Parts A and B.

Original Medicare alone has no cap on your 20% share — Medigap or Advantage helps limit that.

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This article is general information, not advice for your specific situation, and Medicare rules and figures can change. 2026 amounts are from CMS. Tyler Insurance Group is not connected with or endorsed by the U.S. government or the federal Medicare program. For complete details on all your options, contact Medicare.gov or 1-800-MEDICARE.