4 Medicare Costs Not Covered That Can Add Up to More Than $100,000

Medicare pays for a lot, but it leaves major gaps. Many retirees are caught off guard to learn that dental, vision, hearing, and long-term care services are mostly excluded. Over time, those uncovered expenses can climb well past $100,000.

If you want to protect your retirement savings, it helps to know which costs fall outside Medicare and plan ahead for them.

1. Vision care

Routine eye care is not covered by Medicare, and the bills can add up quickly. According to Vision Center, a standard eye exam typically costs $69 to $89 without insurance. At large retail chains, prices often run from $89 to $130, while private optometry offices may charge $100 to more than $250.

Readers.com says a pair of glasses averages about $350 without insurance. Medicare may help with eye injuries or certain screenings for disease, but regular exams and eyewear are paid for out of pocket.

2. Dental services

Dental care is another major gap in Medicare coverage. Original Medicare does not cover cleanings, fillings, crowns, or dentures, even though these are often needed as people age. GoodRx says a cleaning averages $75 to $200, while a filling averages $191, depending on the number of teeth treated and the material used. More extensive procedures cost far more: a root canal averages $1,200, and dentures can range from $1,000 to $28,000.

There are ways to reduce the burden. Some Medicare Advantage plans offered by private insurers include basic dental benefits. If you remain on original Medicare, you may need to budget separately for dental work or consider supplemental dental insurance.

3. Hearing aids

Hearing loss is common among older adults, but Medicare does not pay for hearing aids or routine hearing tests. GoodRx estimates that a single hearing aid can cost between $1,000 and $3,500, depending on the model.

Medicare may cover diagnostic testing or treatment if hearing problems are tied to an injury or medical condition. Still, the devices themselves, along with most fittings and adjustments, are generally your responsibility.

4. Long-term care

The biggest coverage gap may be long-term care. This category includes nursing homes, assisted living, and help at home with daily activities such as bathing and dressing. Medicare does not treat these services as medical care under its rules.

CareScout's 2025 survey found that a private room in a nursing home can cost more than $129,000 per year, while assisted living now tops $74,000 annually in some states.

Medicare only pays for short-term skilled nursing care after a hospital stay, so many retirees must pay themselves, rely on long-term care insurance, or turn to Medicaid if they qualify.

How to get ready for extra healthcare costs in retirement

Understanding Medicare's limits is only the starting point. The next step is building a plan for the expenses it does not cover. One approach is to set aside money in a dedicated health savings account, or HSA. It can also help to create a cushion large enough to cover at least a year of possible medical expenses, especially if you live with chronic conditions.

Working with a financial planner may help you estimate likely costs and decide where to direct your money. Some retirees also downsize their homes or adjust their investments to make room for future healthcare needs.

1. Open and fund an HSA

A Health Savings Account can be a useful way to pay for uncovered medical costs. HSA funds can be used tax-free for expenses such as dental work, eye exams, and hearing aids. If you are still working and enrolled in a qualifying high-deductible health plan, it may make sense to start contributing now.

The IRS sets annual contribution limits for HSAs. For 2026, the limit is $4,400 for individual coverage and $8,750 for family coverage. For 2027, those limits rise to $4,500 and $9,000. People age 55 and older can contribute an extra $1,000 each year.

2. Use retirement savings or Social Security income

If you have money in a 401(k), IRA, or another retirement account, you can set aside part of it for healthcare expenses. Some retirees also use a portion of their Social Security income for that purpose.

Keep in mind that withdrawals from traditional retirement accounts are usually taxed as income, so it is important to plan carefully.

3. Look into supplemental coverage

Beyond Medicare Advantage, you may want to consider Medigap policies or separate insurance for vision, dental, and hearing. These options can help fill the gap between what Medicare covers and what you actually need.

Although they require premiums, supplemental plans may save you thousands over time, especially if you expect ongoing dental or vision expenses. Reviewing coverage and prices each year can help you avoid paying too much or being underinsured.

Bottom line

Medicare offers important protection, but its coverage gaps can lead to large out-of-pocket costs for retirees. Long-term care, hearing aids, and routine dental visits can easily push total expenses above $100,000 over time if you are not prepared.

Taking steps now, such as funding an HSA, reviewing supplemental coverage, and setting aside dedicated savings, can help you stay financially prepared and focus on enjoying retirement.