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Senior man with dental coverage at dentist`s office

Dental, Vision, and Hearing Coverage

Original Medicare does not cover most dental care, dentures, eye exams for prescribing glasses, or hearing aids or exams for fitting them. For this coverage, you should consider a Medicare Advantage (Part C) Plan that offers these benefits.

Dental

Part A will pay for certain dental services if you get them when you are in a hospital. If you have an emergency or complicated dental procedures, Part A will pay for inpatient hospital care but not the dental care. Medicare does not cover cleanings, fillings, tooth extractions, dentures, dental plates, or dental devices. You may consider taking dental insurance.

Vision

Medicare does not cover eyeglasses or contact lenses. If you have cataract surgery to implant an intraocular lens, Part B helps pay for corrective lenses. This includes one pair of eyeglasses with standard frames or one set of contact lenses. But problem is that this benefit will only be offered once per lifetime and they just pay for a standard pair of eyeglasses. If you need upgraded frames, you would be responsible for the cost. So you may consider taking vision insurance.

One more important mention regarding glaucoma. Glaucoma is a group of conditions that can cause blindness. Part B also covers a glaucoma screening every year, but only if you are at high risk for it. This coverage includes people with a family history of glaucoma, people with diabetes, African Americans who are 50 or older, and Hispanic Americans who are 65 or older.

Hearing

Medicare does not cover hearing aids or exams for fitting hearing aids. Part B will cover the diagnostic hearing and balance exams if your doctor or healthcare provider orders them to see if you need medical treatment. While Medicare Supplements can help a little bit, its coverage only activates after Original Medicare pays first. So it will probably not cover hearing aids either. You can consider taking hearing insurance.

Medicare Advantage and Dental, Vision and Hearing

Medicare Advantage Plans (also known as Part C) offer more coverage than Original Medicare. Most plans have prescription drug coverage as well as programs for dental, vision, and hearing care.

These plans cover all the services that Medicare Part A and Part B cover. Original Medicare will cover the cost of hospice care and clinical research studies while you have Medicare Advantage. Part C may choose not to cover services that are not deemed medically necessary under Medicare but will always cover emergency or urgently-needed medical care.

For services that the plan determines are not medically necessary, you will likely pay the full amount. You can appeal that decision. You can also request to see if the plan covers an item or service in advance, which is called an organization determination. Your plan will need to tell you in writing if they deny coverage.

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