UNITED STATES—Hello Toni, my wife’s friend told her that she is receiving a free gym membership from the Medicare Supplement Plan G that she is enrolled in. The Medicare Supplement that we have doesn’t include a gym membership.

I thought only a Medicare Advantage Plan was the way to get a gym membership at no cost. Any truth to this, as I never heard about this before? Thanks, Toni.–Sam from Little Rock, Ark.

Hi there, Sam: It used to be that Medicare Advantage Plans were the only way to get a gym membership at no cost, but now some Medicare Supplement plans office this extra benefit, depending on the insurance company.

Silver and Fit and other membership plans help to enhance Medicare Advantage plans, and during a Toni Says Medicare consultation (in person or by Zoom), whether the client is new to Medicare or changing their Medicare plan, is always advised to make sure  their primary care doctor and any specialists are in that specific Medicare Advantage plans network. (Enrolling in Medicare is explained in the Medicare First Steps Guide available at www.tonisays.com).

“What ISN’T Covered by Part A & Part B?” is discussed in the 2026 Medicare & You handbook on page 55.  This first thing it says is “Medicare doesn’t cover everything.” If you need certain services that Medicare doesn’t cover, you will have to pay for them yourself unless:

-You have other coverage (including Medicaid) to cover the costs.

-You’re in a Medicare Advantage Plan that covers these services.

Some of the items and services that Original Medicare doesn’t cover include:

-Long-term care. See more information about paying for long-term care in the Medicare & You handbook on page 56.

-Eye exams (for prescription eyeglasses and corrective contact lenses).

-Cosmetic surgery.

-Massage therapy.

– Routine physical exams

-Hearing aids and exams for fitting them.

-Concierge care (also called concierge medicine, retainer-based medicine, boutique medical, platinum practice, or direct care).

-Covered items or services you get from doctor or other provider that has opted out of participating in Medicare except in the case of an emergency or urgent need (see page 60 in the handbook for more information).

-Most dental care: In most cases, Original Medicare doesn’t cover dental services like routine cleaning, filling, tooth extraction, or other items like dentures.  There are some cases when Medicare may pay for dental services closely related to covered services like an organ transplant:  see on page 56 of the handbook for more information.

Since Original Medicare does not cover dental services, I would recommend that you talk to your dentist and see which dental insurance plan the dentist office prefers.

There are 2 different types of dental plans:

  • Traditional or indemnity dental insurance plans which are generally higher in premium, and the preventive services are usually covered at 100 percent, basic restorative is generally covered up to 80 percent and major procedures at 50 percent. Many of the traditional/indemnity dental plans may have a wait for services such as fillings, root canals, bridges, crowns, etc.
  • Discount dental plans are generally less expensive than traditional dental plans. These plans provide a discount for services, but your dentist must be part of the plan and agree to give the dental discount.

View www.medicare.gov to explore applying for eyeglasses after cataract surgery which is a limited benefit. Medicare will cover one pair of eyeglasses with standard frames (or one set of contact lenses) after cataract surgery that implants an intraocular lens.  The Medicare Part B Medicare-approved amount will apply for the cataract surgery with your meeting the current year’s Part B deductible and 20 percent out of pocket Medicare amount.

Original Medicare covers the exams for hearing with the same out-of-pocket charge that happens with eyeglasses. When one needs a hearing aid, it is considered an elective benefit, and you will pay for the hearing aid out of pocket.

Remember, with Medicare, what you don’t know WILL hurt you!

Contact the Toni Says Medicare team at info@tonisays.com or call (832) 519-8664 for assistance or to answer Medicare questions. Sign up for the Toni Says newsletter at www.tonisays.com to download Toni’s new Medicare 2026 First Steps guide.