For many people approaching retirement, Medicare is one of the first healthcare topics that comes to mind. It is understandable to think of Medicare as the point when healthcare coverage becomes simpler, but unfortunately that is not the case. One of the most important things to understand is that Medicare does not cover every healthcare expense.
Recent research suggests this is a common misconception. Fidelity's 2026 retirement healthcare research found that 54% of pre-retirees incorrectly believe Medicare will cover ALL of their healthcare expenses. Fidelity also estimates that a 65-year-old retiring in 2026 can expect to spend an average of $185,500 on healthcare and medical expenses throughout retirement, even with standard Medicare coverage. And that estimate does not include potential long-term care expenses.¹
Those numbers do not mean everyone will experience the same costs. They do, however, highlight an important part of preparing for retirement: understanding not only what Medicare covers, but also where coverage may stop.
A Quick Note About What We Mean by "Medicare"
Before looking at some of the more common gaps, it is helpful to make an important distinction.
This blog focuses primarily on Original Medicare, which includes Part A for hospital insurance and Part B for medical insurance. Medicare Advantage plans, also known as Part C, are offered by private companies approved by Medicare. These plans must cover the services Original Medicare covers and may provide additional benefits, including certain dental, vision, and hearing services. Coverage, costs, provider networks, and other plan details can vary.² Medicare Supplement insurance is another type of coverage provided by private companies designed to fill in the gaps that Original Medicare does not cover.
With that distinction in mind, here are five healthcare expenses that may surprise people when planning for retirement.
1. Does Medicare Cover Routine Dental Care?
In most cases, Original Medicare does not cover routine dental care. That can include services many people have received regularly throughout their adult lives, such as cleanings, fillings, tooth extractions, dentures, and dental implants.³
There are exceptions. Medicare may cover certain dental services when they are directly connected to specific covered medical treatments. For example, some dental services may be covered when they are necessary in connection with an organ transplant, certain cancer treatments, a heart valve procedure, or dialysis. The distinction is important. Medicare may cover dental care when it is medically necessary as part of another covered treatment, but that is different from providing ongoing routine dental coverage.
For someone who has been accustomed to receiving dental insurance through an employer, this can be an expense worth considering before retirement rather than discovering after coverage changes.
2. Does Medicare Cover Routine Vision Care?
Original Medicare generally does not cover routine eye exams for eyeglasses or contact lenses.⁴ It also does not usually cover eyeglasses or contact lenses themselves. There are, however, several important exceptions.
Medicare Part B may cover certain eye care when there is a medical reason for it, including eligible diabetic eye exams and certain testing or treatment for conditions such as macular degeneration. Medicare also covers one pair of standard eyeglasses or one set of contact lenses after each cataract surgery in which an intraocular lens is implanted.⁵
This is a good example of why understanding Medicare often requires looking beyond a simple "covered" or "not covered" answer. Routine vision care and medically necessary eye care are treated differently.
3. Does Medicare Cover Hearing Aids?
Original Medicare does not cover hearing aids or exams used specifically for fitting hearing aids.⁶ That does not mean Medicare excludes all hearing-related care. Part B can cover certain diagnostic hearing and balance exams when Medicare's requirements are met. The difference is whether the service is being used to diagnose or manage a medical condition rather than to purchase or fit a hearing aid. For someone who eventually needs hearing aids, the cost may therefore fall outside Original Medicare unless another source of coverage applies.
Some Medicare Advantage plans offer hearing benefits, but those benefits vary by plan. Understanding what a particular plan includes can be an important part of comparing coverage.
4. Does Medicare Cover Long-Term Care?
This may be one of the most important Medicare misconceptions to understand. Medicare does not generally pay for long-term custodial care.⁷ Long-term care often involves help with activities of daily living, such as bathing, dressing, eating, or using the bathroom. That care may take place at home, in an assisted living community, or in a nursing home.
It is also important not to confuse long-term care with skilled nursing facility care. Medicare Part A may cover short-term skilled nursing or rehabilitation services when specific requirements are met. That is very different from ongoing custodial care needed over an extended period.
This distinction can matter significantly when thinking about retirement healthcare expenses. In fact, the Fidelity estimate referenced earlier specifically excludes potential long-term care costs.¹
5. Does Medicare Cover Healthcare Outside the United States?
For people who hope to travel during retirement, this is another area worth understanding. Original Medicare generally does not cover healthcare received outside the United States, although there are limited exceptions.⁸ For example, Medicare may provide coverage in certain situations involving a medical emergency near the U.S. border or particular circumstances involving travel through Canada between Alaska and another U.S. state. There are also limited circumstances in which medically necessary services provided aboard a cruise ship may qualify for coverage. In most situations, however, travelers should not assume their Medicare coverage will follow them internationally.
Some Medicare Supplement Insurance, or Medigap, policies may provide limited foreign travel emergency benefits, and Medicare Advantage coverage outside the United States varies by plan. For anyone planning international travel, understanding those details before leaving the country can help prevent unexpected surprises.
Why These Gaps Matter Before Retirement
It can be easy to think of Medicare as a topic that becomes relevant around age 65. In reality, understanding these potential expenses can be helpful much earlier.
Someone in the middle of a career may still be many years away from Medicare eligibility, but learning what healthcare coverage may look like later can provide useful context when thinking about retirement expenses. Someone approaching retirement may want to understand how employer-sponsored benefits differ from Medicare. Someone already enrolled in Medicare may benefit from periodically reviewing how current coverage aligns with healthcare needs.
The goal is not to predict every medical expense that may occur in the future. That would be impossible. Instead, understanding where Medicare has limitations can help people ask better questions. Will there be a separate dental expense? How might hearing or vision needs be handled? What would happen if long-term care became necessary? Does current coverage fit with plans for international travel?
These are healthcare questions, but they are also financial questions.
Final Thoughts
Medicare plays an important role in healthcare during retirement, but it was never designed to cover every healthcare expense a person may encounter. Routine dental care, certain vision expenses, hearing aids, long-term custodial care, and most healthcare received outside the United States are all examples of costs that may fall outside Original Medicare. Understanding those gaps ahead of time can provide a more complete picture of what healthcare in retirement may actually involve.
Later this month, we invite you to continue the conversation during our educational webinar, Managing Healthcare in Retirement, presented by Miles Fleming. During the webinar, Miles will explore Medicare in greater detail and discuss important healthcare considerations that can arise as people prepare for and move through retirement.
If you would like to learn more, please visit the Events page of our website for registration information.
References
Fidelity Investments, 2026 Retiree Health Care Cost Estimate, July 21, 2026. Fidelity estimates that a 65-year-old retiring in 2026 can expect to spend an average of $185,500 on healthcare and medical expenses throughout retirement. The estimate assumes Original Medicare Parts A and B and Medicare Part D and excludes potential long-term care expenses. Fidelity also reports that 54% of pre-retirees incorrectly believe Medicare will cover all of their healthcare expenses.
Read the Fidelity researchMedicare.gov, Your Medicare Coverage Options. Medicare Advantage plans must cover services covered by Original Medicare and may offer additional benefits, such as vision, hearing, and dental services.
Learn about Medicare coverage optionsMedicare.gov, Dental Services. Original Medicare does not cover most routine dental services, including cleanings, fillings, dentures, and implants, although certain dental services related to covered medical treatment may qualify.
Read about Medicare dental coverageMedicare.gov, Routine Eye Exams. Original Medicare does not cover routine eye exams for eyeglasses or contact lenses.
Read about routine eye exam coverageMedicare.gov, Cataract Surgery and Eye Care. Medicare Part B covers certain medically necessary eye services and one pair of standard eyeglasses or contact lenses after qualifying cataract surgery.
Read about cataract surgery coverageMedicare.gov, Hearing Aids and Hearing Exams. Original Medicare does not cover hearing aids or exams for fitting hearing aids, although Part B covers qualifying diagnostic hearing and balance exams.
Read about hearing aid coverage
Read about diagnostic hearing and balance examsMedicare.gov, Long-Term Care. Medicare does not pay for most long-term custodial care. Limited skilled nursing facility care may be covered separately when Medicare requirements are met.
Read about long-term care coverage
Read about skilled nursing facility coverageMedicare.gov, Travel Outside the U.S. Original Medicare generally does not cover healthcare outside the United States, although limited exceptions apply.
Read about Medicare coverage while traveling