Original Medicare means Part A (hospital) and Part B (medical). It covers a great deal, and it also leaves out some things people assume are included. This is Medicare’s own list, in plain language, with the exceptions worth knowing. Source: Medicare.gov, What’s not covered?, 2026.
The list
- Most dental care. Cleanings, fillings, extractions, and dentures are on you. The exception is dental work that’s part of certain medical treatments, such as before a heart valve repair or replacement, an organ transplant, cancer treatment, or dialysis for end-stage kidney disease.
- Eye exams for prescription glasses, and the glasses themselves. Part B doesn’t usually cover eyeglasses or contact lenses. The one exception: after cataract surgery that implants an intraocular lens, Part B covers one pair of glasses with standard frames, or one set of contact lenses. You pay 20% of the Medicare-approved amount after the Part B deductible, and any upgrade to the frames is on you. Source: Medicare.gov, Eyeglasses and contact lenses, 2026.
- Hearing aids, and the exams to fit them.
- Long-term care. This is the one that surprises families most, and it deserves its own post.
- Cosmetic surgery.
- Massage therapy.
- Routine physical exams. See the next section, because this one causes real bills.
- Concierge care. Also called retainer-based, boutique, or direct care: the membership fee a practice charges to be a patient there isn’t covered.
- Care from a provider who has opted out of Medicare, except in an emergency.
Source: Medicare.gov, What’s not covered?, 2026, unless noted.
The physical that isn’t covered, and the visit that is
Medicare doesn’t cover a routine physical. It does cover a yearly “Wellness” visit, once every 12 months, starting 12 months after you’ve had Part B or had your “Welcome to Medicare” visit. You pay nothing for it if your provider accepts assignment. Source: Medicare.gov, Yearly Wellness visits, 2026.
Here’s the catch. The Wellness visit is a conversation with your provider to build a prevention plan. It isn’t a physical exam. If your provider does extra tests or services during the same appointment that aren’t part of that preventive benefit, coinsurance and the Part B deductible may apply. And if Medicare doesn’t cover the extra service at all, a routine physical being the classic example, you may pay the full amount for that part. Source: Medicare.gov, 2026.
So a “free annual visit” can produce a bill when the visit turns into a physical partway through. If that’s happened to you, the line items on the bill tell you which part was the Wellness visit and which part wasn’t.
How to check one specific thing
Medicare.gov has a coverage lookup: type in a test, item, or service, and it tells you whether Original Medicare covers it and what you’d generally pay. That’s the place to check before a procedure, not after. Source: Medicare.gov, Is my test, item, or service covered?, 2026.
Where the gaps can get filled
Some Medicare Advantage plans, Medicare Cost Plans, and PACE programs include some dental, vision, or hearing coverage that Original Medicare doesn’t. What’s included and what it costs is set by each plan, not by Medicare, and it varies a lot, so read the specific plan’s documents rather than the headline. Source: Medicare.gov, What’s not covered?, 2026.
The trade-offs between those plans and Original Medicare are bigger than dental and vision, and they’re the subject of the Medicare Advantage vs Medigap guide. If you’re brand new to this, start with Medicare Parts A, B, C, and D, explained simply.