Medicare Plans by Turning 65 Solutions


Dental, Vision, and Hearing

Original Medicare covers dental, vision, and hearing only when it is linked with inpatient or outpatient medical needs which require medical necessity. We’ll explain what Medicare covers and what you’ll have to buy additional coverage for, should you need it. If you need additional coverage, we can help!

Medicare and Dental Insurance

Medicare has restricted dental coverage that protects your overall health so that another Medicare-covered health service can run smoothly. It does not cover teeth cleanings, fillings, dentures (full or partial), routine checkups, or most tooth extractions. You can only gain this type of coverage through a standalone dental insurance plan or through a Medicare Advantage plan that may offer these benefits. Among stand-alone dental insurance plans, beneficiaries can also purchase dental, vision, and hearing plans altogether to get covered for all three major services that aren’t normally covered under Original Medicare. 

Stand-alone dental insurance coverage provides benefits like:

  • regular checkups and cleanings: usually twice a year and out-of-pocket coinsurance may be required 
  • tooth extractions
  • cavity cleanings
  • x-rays
  • root canals and other repair network work 
  • bridges, crowns, and implants
  • complex dental procedures like oral surgery
  • retainers

However, dental insurance plans usually don’t provide coverage for orthodontics (braces), any dental care that is related to pre-existing conditions, or any dental procedures that are considered cosmetic.

Also, the range of coverage you get may depend on which type of dental insurance plan you choose, and from which company, you are choosing. You can typically choose plans with preventive, basic, or major coverage. Preventive coverage includes routine checkups and cleanings, and also may exclude deductibles from their plans. Basic coverage includes fillings and some repair work, whilst major coverage includes more complex work like surgeries, bridges, crowns, dentures, etc. 

The dental insurance plan costs depend on which range of coverage you like to choose. If you only want to get routine checkups and preventative services your monthly premiums may be as low as 20$ per month. However, if you would like the widest range of coverage which includes preventive, basic, and major dental services, your costs can go up to 80$ per month.

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Does Medicare Include Vision Insurance?

Most of the time, Original Medicare does not cover eyeglasses, routine eye exams, or contact lenses. It will often pay for these things after cataract surgery that implants an intraocular lens. As you can tell, this is a very specific surgery.

Following the surgery, Medicare Part B will help cover corrective lenses, one pair of eyeglasses, or one set of contact lenses that an ophthalmologist provides.

But there is a disadvantage — 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.

A 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.

An ocular prosthesis, artificial eye, or glass eye is covered for patients with the absence or shrinkage of an eye due to trauma, birth defects, or surgical removal. It also covers a replacement, which is usually every 3-5 years.

Part B will cover various diagnostic tests and treatments for eye diseases and conditions. If you want routine eye exams and multiple pairs of eyeglasses or contacts (or an upgrade to the standard frames), an inexpensive, independent vision plan is probably your best option. Certain Medicare Advantage plans can include suitable coverage, too. But, you should talk to a licensed Medicare insurance agent to confer the details of the plan.

But, Medicare typically doesn’t cover vision services if not medically necessary. If you want to get covered for routine eye exams, eyeglasses frames, eyeglasses lenses, and contact lenses, or LASIK surgery (not fully cost but often you get a coupon for a discount) you will need to enroll in a stand-alone vision insurance plan. Costs may be up to 15$ a month.  Costs also may include copays and deductibles and those prices may vary from plan to plan and from company to company.


How Do Medicare and Hearing Insurance Coexist?

If you just have Original Medicare, hearing aids are not covered. Part B covers some hearing tests, like diagnostic hearing and balance exams. You must go through your primary care provider for your inaugural screenings. Once they suggest additional treatment, your Part B coverage will pay for a percentage of the costs.

While Medicare Supplements can help a little bit, its coverage only activates after Original Medicare pays first. So, sadly, it will probably not cover hearing aids either. However, most Medicare Advantage plans include hearing benefits in their coverage. if you don’t want or don’t have a Medicare Advantage plan you will have to choose a stand-alone insurance policy that offers coverage for hearing benefits.

An independent dental, vision, and hearing plan will help cover the expenses of hearing aids and other services, such as routine exams. Also, a Medicare Advantage plan with additional hearing benefits might offer coverage.  Be aware that you can’t get dental, vision, and hearing coverage with the Medicare Supplement plan. If you have some of these plans you must purchase stand-alone policies to get covered.  However, there are not many stand-alone hearing plans, so maybe the best option is to purchase dental, vision, and hearing altogether to be sure you will get proper coverage.   But before you commit, consult a licensed Medicare agent to discuss the specifics of the plan.

Turning 65 Solutions can help, so give us a call at 830-328-4353!