What does Medicare not cover?

Medicare is genuinely comprehensive for medical care, but there are real gaps that catch people off guard if they're not expecting them.The biggest one is long-term custodial care. If you need help with daily activities like bathing, dressing, or eating because of age or disability, Medicare doesn't pay for that, whether it's in a nursing home or at home. That kind of ongoing personal care is typically covered by Medicaid for people who qualify financially, or by long-term care insurance.Dental care is mostly excluded. Medicare doesn't cover routine cleanings, fillings, dentures, or most extractions. There are narrow exceptions for dental work that's directly tied to a covered medical procedure, but that's not the norm. Some Medicare Advantage plans include limited dental benefits, so this is worth asking about.Vision coverage is limited. Medicare covers treatment for diseases of the eye, like glaucoma or cataracts, but not routine eye exams or eyeglasses. Again, some Advantage plans add this.Hearing is similar. Medicare doesn't cover routine hearing exams or hearing aids, though some Advantage plans offer an allowance toward them.Prescription drugs filled at a pharmacy aren't covered under Parts A and B. You need Part D or a drug-inclusive Advantage plan for that.Care received outside the United States generally isn't covered, with very limited exceptions for emergencies near the Canadian or Mexican border.Knowing these gaps upfront helps you plan for them rather than discover them at the worst possible moment.