Most of our clients are surprised to hear that Medicare doesn’t offer much coverage when it comes to dental, vision, and hearing services. We’ve come to understand that all three of these areas play a vital role when it comes to our overall health, so it’s a wonder Medicare doesn’t include these in its benefits.
That’s not to say that Medicare won’t pay for any services. It does offer coverage for more extreme services like cataract surgery. However, most of your day-to-day, routine, and preventive treatments aren’t covered at all.
Let’s take a closer look at each of these three areas to find out what Medicare offers and ways to get coverage for dental, vision, and hearing services.
Does Medicare Include Dental Insurance?
Dental coverage is probably where Medicare is most lacking. Now, when we say “Medicare,” we’re talking about Original Medicare, which consists of Parts A and B.
Medicare Part B will cover dental treatment in a few instances, which are not common. For example, Part B would consider coverage in these cases:
- An oral exam needed prior to a kidney transplant
- Reconstruction of the jaw after an accident
- Tooth extractions prior to jaw radiation treatment
- Exams required before oral surgery
As you can see, many of us won’t experience these events. When it comes to other dental treatment that you’re more familiar with, like cleanings, crowns, bridges, fillings, root canals, and dentures, Medicare does not offer any coverage.
Does Medicare Include Vision Insurance?
Medicare offers vision coverage similar to how it offers dental coverage. It’ll help pay for a few more major things but doesn’t offer assistance for routine services.
First, let’s talk about eye exams, sometimes referred to as eye refractions. Medicare will not pay for routine checkups unless a more serious concern is present. For example, Medicare covers a glaucoma screening every 12 months, but only for people at high risk for it. High-risk people include those with diabetes, those with a family history of glaucoma, African Americans age 50 and older, and Hispanic Americans age 65 and older.
Medicare will also pay for certain diagnostic tests and treatment if you are diagnosed with macular degeneration.
Second, let’s look at eyeglasses and contact lenses. In most cases, these aren’t covered. However, there are some exceptions. If you have cataract surgery that includes the implantation of an intraocular lens, Medicare will pay for one pair of eyeglasses or contacts. The downside is that it will only cover this once per lifetime, and there are limitations on the kind of frames they allow.
Lastly, eye prostheses are covered for patients with the absence or shrinkage of an eye due to birth defects, trauma, or surgical removal. Medicare will cover a replacement every five years.
All these services fall under Medicare Part B. For each, the Part B deductible applies, then you pay 20% of the Medicare-approved amount.
Medicare and Hearing Coverage
It’s time to talk about hearing exams and hearing aids.
Medicare does offer some coverage for hearing tests, as long as your doctor thinks they are medically necessary. Hearing exams used to diagnose or treat a hearing condition are allowed under Medicare.
You can also have an exam done every 12 months without your doctor’s permission if you have non-acute hearing conditions, such as hearing loss that occurs over several years, or if you need diagnostic services related to hearing loss that has been treated with a surgically-implanted hearing device.
Medicare does not cover hearing aids or the exams needed to fit the hearing aids.
Like vision services, hearing benefits also fall under Medicare Part B. Once you meet the deductible, Medicare pays 80% of approved services.
Get Coverage for Dental, Vision, and Hearing Services
Not impressed with what you’ve learned so far? We understand. Most people don’t look forward to paying out-of-pocket for dental, vision, and hearing services. In fact, many people don’t have it in their budget to pay for these expensive things.
Fortunately, you’ve got options! We’ll review a couple of them here, but remember that you can call Bobby Brock Insurance when you’re ready to get personalized advice.
We’ve all seen the TV commercials about Medicare Advantage plans, right? They offer endless benefits and convenient coverage. While we don’t recommend believing everything you hear about these plans, some things are actually true!
Medicare Advantage plans are also referred to as Medicare Part C. They’re an all-in-one alternative to Original Medicare. Every Medicare Advantage plan must offer at least as much coverage as Parts A and B. However, most plans offer much more.
Dental, vision, and hearing benefits are one place Medicare Advantage plans shine. Nearly all of them will have more coverage than Original Medicare when it comes to these three areas. For example, we’ve seen plans offer several thousands of dollars in dental benefits and even some that include dental implants in their coverage.
You’ll need to know more about Medicare Advantage plans before deciding this is the best option for you, but they are a great option for many people.
Dental, Vision, Hearing Insurance Plans
Another simple option is to add a Dental, Vision, Hearing (DVH) policy to your insurance portfolio.
We work with several insurance companies that offer DVH plans. They’re a great way to supplement your coverage under Original Medicare if you’d rather not enroll in Medicare Advantage.
Carriers often bundle these benefits into one plan since they are aware that Medicare is lacking in those areas. Each plan is different, so you’ll need to look at each area to find out what they cover.
Of course, you can also choose to enroll in separate plans altogether. Some beneficiaries are not as concerned with vision and hearing as they are with dental, so they choose to enroll in a dental-only insurance plan.
There are many possibilities when it comes to dental, vision, and hearing coverage. By working with one of our advisors at Bobby Brock Insurance, you can find out which option makes the most sense for you.