Medicare, the federal government’s program that provides health care to those 65 and older, while a confusing package of rules and regulations, is generally highly regarded by its users. That, of course, matters little to the ilk of Paul Ryan and PEOTUS Donald Trump who appear hell-bent on replacing it with a voucher program. It is the ultimate “if it ain’t broke, why fix it?” situation and already seniors are justifiably getting concerned.
Frankly, if any changes are to be made to the program, we’d like to start with this short list of five things that traditional Medicare unbelievably does not cover.
1. Hearing aids and exams for fitting them.
Hearing loss is among the single most-isolating things that can happen to a person. And it is absolutely age-related. Nearly 25 percent of those aged 65 to 74 and 50 percent of those who are 75 and older have disabling hearing loss, reports the National Institute on Deafness and Other Communication Disorders. If you can’t hear conversations, you stop socializing. You stop enjoying dining out or going to movies. Ambient noise is the enemy and you just avoid those social situations where noise bounces off walls and renders you unable to distinguish words. That leads to loneliness, one of the big bugaboos for the elderly.
Hearing loss pretty much goes hand-in-hand with aging. And yet Medicare doesn’t cover the simple fix: hearing aids. It needs to.
2. Dentures and most dental care.
Teeth wear out. Through a lifetime of chewing, grinding, and biting, tooth enamel ― the hard, outer layer of your teeth ― gets worn away. We need teeth to chew and properly digest our food. And nope, Medicare won’t help seniors maintain their teeth or replace them when they can no longer be maintained.
While prevalence of both partial and total tooth loss in seniors has decreased from the early 1970s until the latest (1999-2004) National Health and Nutrition Examination Survey, 28 percent of people over age 65 have no remaining teeth.
While by and large, Medicare won’t cover dental services, there are a few exceptions. For example, if you hurt your jaw in an accident, Medicare may cover jaw reconstruction if it is medically necessary to treat your injury. Medicare also may cover extraction of teeth to prepare the jaw for radiation treatment for jaw-related neoplastic diseases. Medicare would generally cover dental examinations prior to a complicated procedure (such as a kidney or heart transplant) that requires an oral exam.
Some Medicare Advantage programs include dental services, but traditional Medicare does not.
3. Eye exams related to prescribing glasses.
Medicare doesn’t cover routine eye exams for eyeglasses or contact lenses. Medicare Part B covers some preventive and diagnostic eye exams such as glaucoma tests and annual exams for diabetics.
Approximately one person in three has vision problems by the age of 65, says the American Family Physician. The most common causes of vision loss among the elderly are age-related macular degeneration, glaucoma, cataract and diabetic retinopathy. According to the Mayo Clinic, about half of all 65-year-old Americans have some degree of cataract formation. It’s estimated that by 2020 more than 30 million Americans will have cataracts.
4. Routine foot care.
When the feet go, so goes the body. Medicare will not cover the cutting or removal of corns and calluses; trimming, cutting, and clipping of nails; hygienic or other preventive maintenance, including cleaning and soaking the feet. Toot, toot Tootsie, good bye!
5. Home health services.
Long-term care is seen as custodial care ― basically help with the personal tasks of everyday life. The official verbiage is “activities of daily living” ― and the difference between that and skilled nursing care is huge in the eyes of Medicare.
Medicare doesn’t cover long-term care, if that’s the only care you need. Most nursing home care is custodial care. It will cover care in a long-term care hospital or skilled nursing care in a skilled nursing home.
Medicare does not cover at-home 24-hour caregiving, meals delivered to your home, homemaker services or personal care ― the things that might make it possible for more people to remain in their own homes instead of the more costly skilled nursing homes. What possible sense does that make?
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