Original Medicare doesn’t include routine dental, vision, or hearing coverage. While Medicare covers a lot of benefits, they don’t cover everything. However, there are plan options for seniors seeking the help they need.
Read more about your dental services, vision care, and hearing coverage options.
Does Medicare cover dental, vision, or hearing?
Part A and Medicare Part B can only cover dental, vision, or hearing services your primary doctor or hospital staff can provide. For example, your primary care provider may do a quick hearing or eye exam during your Annual Wellness Visit. Also, dental care will fall under Part A if you need jaw surgery in a hospital.
Dental, vision, and hearing coverage is tops among Medicare beneficiaries complaining about Medicare coverage. Since it’s not considered medically necessary, it’s not covered by Original Medicare,
Medicare beneficiaries need to find vision coverage, dental benefits, and hearing care through private insurance since Medicare coverage doesn’t include these things. Enrollment for coverage is simple, and you can choose the benefits that make the most sense for your needs.
Since these benefits aren’t required to follow Medicare laws, you can sign up anytime.
Does Medicare pay for dental care in 2023?
Medicare Part B will cover dental costs that are part of another covered service, such as jaw surgery. However, Medicare excludes dental coverage that you’ll need for the health of your teeth. For example, Medicare won’t cover preventive dental exams, x-rays, routine cleanings, or comprehensive dental services.
Does Medicare cover routine eye exams?
Part A would cover vision care if you have a traumatic eye injury and you’re admitted to the hospital.
Medicare Part B covers cataract surgery, vision correction after surgery, and yearly glaucoma screenings for high-risk beneficiaries. Part B also covers eye prostheses for beneficiaries with a congenital disability of the eye, surgical removal, or trauma. Those with a prosthetic eye have Medicare coverage for polishing and resurfacing twice yearly.
Part B covers ocular photodynamic therapy (verteporfin) for macular degeneration patients. You’ll need coverage for routine exams, eyeglasses, contact lenses, and other vision services.
Does Medicare have hearing benefits?
Medicare won’t cover hearing aids or exams for fitting a hearing aid because they don’t consider hearing aids medically necessary. Also, Medicare doesn’t cover hearing exams administered by an audiologist. Part B covers the service if your primary healthcare provider does the hearing exam during your Annual Wellness Visit.
Do Medicare Advantage plans include dental, vision, or hearing coverage?
Many Part C Medicare Advantage plans cover dental, vision, or hearing benefits. Some plans require you to pay an additional amount, and other health plans include the benefits for no extra fee.
When you use a Part C Medicare plan, you may pay a copayment for services or supplies rendered. Most Medicare Advantage plans cover routine or preventive care instead of comprehensive coverage. For example, the plan may cover cleaning and an x-ray, but you’re on your own if you need dental implants or dentures.
Some Medicare Advantage plans offer comprehensive dental benefits. Check with a licensed insurance agent to see what’s available in your area. Before deciding on a health insurance policy, consider the benefits offered and your personal needs. In addition, many Medicare Advantage plans offer coverage for vision and hearing.
Can Part D help with dental, vision, and hearing costs?
Yes! Suppose you have a medication on your plan’s formulary prescribed by your dentist, ophthalmologist, or audiologist. In that case, your prescription drug plan can help. For example, you may need an antibiotic before dental surgery, or your vision provider could prescribe eye drops.
What is the Medicare Dental, Vision, and Hearing Benefit Act?
In July of 2021, the House introduced an amendment to the Social Security Act to provide coverage for dental, vision, and hearing care under traditional Medicare.
Of course, the bill would include special payment limitations, coinsurance requirements, and rules. Although, a simplified version of coverage would be more likely.
FAQs
Does Medicare cover dentures?
No, Medicare won’t cover dentures or dental implants. Without additional insurance, you’ll pay 100% out-of-pocket dental care costs.
Depending on the Medicare Advantage plans in your area, you may be able to find one with coverage for dentures.
Does Medicare cover root canals?
Medicare provides no coverage for root canals. However, some Part C plans do cover root canals. Still, you’ll want to check the explanation of benefits to confirm coverage.
Does Medicare cover tooth extractions?
Tooth extractions won’t have coverage through Medicare. Like other dental services, some Medicare Advantage plans include this coverage.
Does Medicare cover fillings?
No, Medicare won’t cover dental fillings because the federal program doesn’t consider dentistry medically necessary. Some Medicare Advantage plans will include coverage for fillings.
Does the Medicare program cover cataract surgery?
Yes, Medicare will cover cataract surgery that involves an intraocular lens implant. This implant helps your eyes focus. Medicare won’t cover advanced implants. You may have to pay some or all of the costs if you need those.
Does Medicare cover glaucoma testing?
Yes, Medicare covers glaucoma testing for those that are high-risk. The test is covered every 12 months. Medicare covers glaucoma medications, treatments, eye drops, laser therapy, and eye surgery. When Medicare approves your eye care, Part B covers 80% of the cost after you meet your deductible.
Does Medicare cover hearing loss screenings or hearing exams?
No, Medicare won’t cover the cost of a hearing loss screening or a hearing exam. Also, Medicare doesn’t cover hearing aids or hearing aid fittings. Many Medicare Advantage plans include hearing exams.
What if I’m a Medicare beneficiary with a low-income needing hearing, dental, and vision coverage?
Depending on your state’s Medicaid program, you may qualify for help with the cost of hearing, dental, and vision care. Those eligible for Medicare and Medicaid are eligible for a Medicare Advantage Special Needs Plan.
How to get Medicare coverage for dental care, vision benefits, and hearing services
Medicare Supplement plans can cover the 20% you’d otherwise be responsible for paying on covered services. Some Medigap insurance plans can help you by covering your Part A or B deductibles. If Medicare approves the claim, Medigap approves the claim.
Whether you need help finding additional Supplemental Insurance for Medicare or dental, vision, and hearing insurance, our licensed agents can help you.
Call us today. Or you can fill out our online rate form to get rates for plans available in your area.
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