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In short Common gaps What you pay even for covered care Ways to cover the gaps Prescriptions Paying cash for things Medicare skips Check the current rules Common questions SourcesOriginal Medicare (Part A and Part B) does not cover everything. Medicare.gov says that for items and services it does not cover, you pay yourself unless you have other coverage that helps. The common gaps include routine dental care, eye exams for glasses, and hearing aids.
Common gaps
In most cases, Original Medicare does not cover routine dental care like cleanings, fillings and extractions, or dentures and implants. It also generally does not cover eye exams for glasses or contact lenses, or hearing aids. Some Medicare Advantage plans include some of these benefits, so check the specific plan.
What you pay even for covered care
For 2026, CMS lists the Part B deductible at $283. After you meet it, you typically pay a share of the cost of covered Part B services. Original Medicare has no yearly cap on what you pay out of pocket, which is one reason people add other coverage.
Ways to cover the gaps
Options include a Medicare Advantage plan, a Medigap policy for costs that Original Medicare leaves, or help through Medicaid or a Medicare Savings Program if you have a low income. Your State Health Insurance Assistance Program (SHIP) offers free counseling on these choices. You can find yours at shiphelp.org.
Prescriptions
Prescription drug coverage comes from Part D or a Medicare Advantage plan that includes it. For 2026, CMS lists a $2,100 out-of-pocket threshold for Part D. For drugs you pay for yourself, see our guides on prescription discount cards and four dollar generics.
Paying cash for things Medicare skips
When Medicare does not pay, the cash price matters. Community health centers charge on a sliding scale for many services, see community health centers. For typical cash prices on common labs and scans, see our lab test prices and scan prices.
Check the current rules
Medicare costs and rules change each year. Confirm details on Medicare.gov or call 1-800-MEDICARE before you decide.
- Medicare.gov - What Original Medicare does not cover
- Medicare.gov - Dental services
- CMS - 2026 Medicare Parts A and B premiums and deductibles
Pymander is not a replacement for a physician and does not provide medical advice, diagnosis, or treatment.
Common questions
Does Medicare cover dental?
In most cases, no for routine care. Medicare.gov lists limited exceptions, such as some dental services needed during a hospital stay.
Does Medicare cover hearing aids?
Original Medicare generally does not cover hearing aids. Some Medicare Advantage plans offer a benefit.
What is the 2026 Part B deductible?
CMS lists it at $283 for 2026.
Where can I get free help choosing coverage?
Your State Health Insurance Assistance Program (SHIP) provides free counseling. Find yours at shiphelp.org. Pymander is available in all 50 states.
Pymander is not a replacement for a physician and does not provide medical advice, diagnosis, or treatment.