Retirement should be a time to relax and enjoy life, but unexpected healthcare expenses could quickly derail those plans. Many retirees may naturally assume Medicare will cover all their medical needs—only to potentially discover coverage gaps that could leave them with high out-of-pocket costs. From long-term care to dental and vision services, knowing up front what Medicare doesn’t cover could be key for protecting your health and finances.

Fortunately, with the right retirement planning, you can help meet your healthcare needs. Let’s explore some of the most common gaps seen in Medicare coverage and how you can help bridge them effectively.

Since long-term care is among the most expensive healthcare needs in retirement, planning can be essential. Considering how you’ll manage these costs ahead of time may help protect your savings and help provide you with peace of mind.

What Does Medicare Not Cover in Retirement?

Original Medicare does not cover several key healthcare services that many retirees need. These gaps can lead to high out-of-pocket costs if you're unprepared. Common Medicare coverage gaps include:

  • Long-term care (nursing home or home-based help with daily activities)
  • Prescription drugs not included in Part A or B
  • Routine dental, vision, and hearing care
  • Medical care during foreign travel

Long-Term Care: A Major Gap in Medicare Coverage

Medicare Does Not Cover Long-Term Care Services

Many retirees may be surprised to discover that Medicare and Medigap don’t cover long-term care services. These services may include assistance with daily activities such as bathing, dressing, and eating, whether provided in a nursing home, assisted living facility, or home.
This gap in Medicare coverage could cost you. Especially since approximately 70% of seniors will need these services at some point.1

Long-Term Care Planning Is Essential

Since long-term care is among the most expensive healthcare needs in retirement, planning can be essential. Considering how you’ll manage these costs ahead of time may help protect your savings and help provide you with peace of mind.

Prescription Drug Coverage Gaps in Medicare

What Medicare Part D Covers

While Original Medicare (Parts A and B) offer some prescription drug coverage, Part D helps pay for brand-name, generic, and a more extensive list of outpatient prescription drugs. Medicare Part D is optional and works as a standalone prescription drug plan (PDP) if you are receiving your hospital and medical benefits from Original Medicare. Medicare Part D plans vary in terms of monthly premiums, deductibles, and the list of drugs covered.

Medicare Advantage and Prescription Coverage

While some Medicare Advantage plans (Part C) include Part D, you will want to ensure it does. If you join a Medicare Advantage plan that doesn’t offer drug coverage, in most cases, you won’t be able to add a separate Medicare drug plan.

How to Choose the Right Plan

To know what is right for you, you should consider what medications you currently take, what PDPs are available in your area, and what you are willing to pay for out-of-pocket costs. Also, if you have or are eligible for other benefits or programs such as the Department of Veteran Affairs “Meds by Mail”, food stamps or state housing, you will want to understand any changes that may occur if you enroll in Medicare Part D. Medicare has a great online tool that may help you decide.

Routine Dental, Vision, and Hearing Care

Medicare Does Not Cover Routine Preventive Services

Unfortunately, Medicare does not cover routine or preventive dental, vision, or hearing care—services many retirees may need to maintain their quality of life.

Why This Gap in Coverage Matters

These costs can add up quickly, making essential care difficult to afford for those on a fixed income. Not everyone has the same needs, but there is a wide selection of insurance coverage and discount cards to fit your individual needs.

How to Plan Ahead for These Expenses

To help protect your finances and health, consider setting aside money for these medical expenses in a Health Savings Account (HSA) before you retire or looking into supplemental insurance plans. Taking steps now can help you avoid unexpected costs later and aid you in maintaining your health and independence throughout retirement.

Foreign Travel and Emergency Care Abroad

Medicare Has Limited Coverage Outside the U.S.

Dreaming of international adventures in retirement? Before you pack your bags, it’s crucial to understand Medicare’s limitations regarding coverage outside the United States. Original Medicare typically does not cover medical expenses abroad, which means you could face high costs if you experience a health emergency on your trip.

Why This Gap Matters for Retirees

This lack of Medicare international coverage can be a major concern for most retirees. This may not be sufficient for long trips or if you need comprehensive care. Additionally, many older adults have existing health conditions, with about 93% of retirees having at least one chronic condition and nearly 80% managing two or more, according to the National Council on Aging.2 If you’re traveling abroad, planning for managing your health may be important to consider.

What Medigap Covers—and What It Doesn’t

While there are six Medigap Plans (Part C, D, F, G, M, and N) that offer some foreign travel emergency coverage, it won’t cover all of it. Purchasing travel insurance can be an excellent way to protect yourself from unexpected medical expenses. Many travel policies may include coverage for medical emergencies and evacuation services. For example, the average cost of a medical evacuation from part of Europe to the United States is estimated to be $65,000 to $90,0003—an expense that travel insurance could cover, providing help for both financial relief and peace of mind.

How to Get Comprehensive Travel Health Coverage

If you’re planning extended trips or want comprehensive coverage, consider combining travel insurance with a Medigap policy for foreign emergency care. While Medigap plans offer some coverage, travel insurance may be able to supplement this to help ensure you’re protected.

Let’s Build Your Secure Retirement Plan Together

Original Medicare is an essential foundation for your healthcare in retirement, but it’s not the whole picture. By understanding Medicare coverage gaps and taking proactive measures, you can help protect yourself from unexpected healthcare expenses and focus more on enjoying your retirement years.

Ready to take the next step in securing your healthcare coverage? Contact American Fidelity Retirement Services today. Let us help you build a retirement plan that gives you peace of mind—and the freedom to live your best life.

This information is general in nature and should not be considered financial, legal, or tax advice. Consult an attorney or a tax professional regarding your specific situation.

This blog is up to date as of August 2025 and has not been updated for changes in the law, administration, or current events.

Sources

1 Consumer Affairs Journal of Consumer Research. “Long-Term Care Statistics.” Accessed 25 Jul 2025. Updated 6 Feb 2024. https://www.consumeraffairs.com/health/long-term-care-statistics.html.

2 National Council on Aging (NCOA). “Get the Facts on Healthy Aging.” Accessed 29 Jul 2025. Published 9 May 2025. https://www.ncoa.org/article/get-the-facts-on-healthy-aging/.3

3 Forbes Advisor. “What Is Medical Evacuation Coverage in Travel Insurance?” Accessed 29 Jul 2025. Updated 11 Oct 2024. https://www.forbes.com/advisor/travel-insurance/medical-evacuation-coverage/.