Navigating through Medicare coverage and benefits can be tricky at times, especially when it comes to figuring out what is covered by Original Medicare, and what might require a Medicare Advantage plan. Here, we’ll break down what coverage options are available to you for vision and dental care with Medicare.
Does Medicare Part A and B Cover Dental and Vision?
Medicare parts A and B, also known as Original Medicare, do not typically cover dental or vision services. Part A covers hospitalizations, while Part B covers medical services such as doctors’ visits. Once you turn 65, you’re usually eligible for Part A at no cost if you’ve paid into the Medicare system through your taxes for at least 10 years. If you’re a citizen or permanent resident of the United States, you’re eligible for Part B.
The only situation where Original Medicare may cover some dental or vision services is in complicated or serious cases where a hospital stay is required, like if you severely injure your jaw or eye. In this case, Original Medicare may cover some expenses related to dental or vision work.
Does Medicare Advantage Cover Dental and Vision?
The short answer is sometimes. Medicare Advantage plans, or Medicare Part C, offer all the services included in Original Medicare and other additional services and benefits. These plans are offered through private insurance companies like Priority Health.
Some Medicare Advantage plans include coverage for routine vision and dental care. However, this is not true of all Medicare Advantage plans so it’s important to thoroughly read the details of what the plan covers before signing up. These plans operate similarly to traditional health coverage and often include copays, coinsurance, and deductibles — be sure to research how dental and vision services will be covered so you know how much out-of-pocket you may be spending.
Does Medigap Cover Dental and Vision?
Medigap plans, or Medicare Supplemental insurance, are meant to help cover costs that Original Medicare does not, such as copayments, coinsurance, and deductibles. However, it cannot be used to help cover costs for dental and vision services. Some Medigap plans such as those offered through Priority Health do offer discounts on vision services.
Medicare Covered Dental Services
The specific dental services you have coverage for through Medicare will depend on your plan. Most Medicare Advantage plans that offer dental coverage will include basic services such as teeth cleaning, routine x-rays, and fillings, but each is different so it’s important to learn the specifics before choosing a plan.
Consider what kind of dental care you anticipate needing when selecting a plan. For some people, routine care will cover their dental needs, but others may need to consider coverage for dentures or surgery when choosing a plan. Coverage for additional dental services or surgeries such as root canals may require the purchase of an additional package.
For example, Priority Health’s Medicare Advantage plans include preventive dental services such as cleanings and exams, and you can purchase additional coverage through the Embedded Dental, Visions and Hearing package or an Enhanced Dental and Visions package.
Medicare Covered Vision Services
Just like with dental care, the specific vision care covered by your Medicare Advantage plan will depend on the plan. Basic vision benefits included in Medicare Advantage plans are often routine eye exams, retinal imaging and an allowance to be spent on eyewear.
Priority Health’s Medicare Advantage plans include all of the above vision services and opportunities to upgrade and receive an increased amount for eyewear spend through the Enhanced Vison and Dental package.
Finding a Medicare Plan with Vision and Dental Coverage
The Medicare Annual Election period is the time of year when you can make changes to your Medicare plan for the upcoming year. This year’s AEP is from Oct. 15, 2020 to Dec. 7, 2020. If you’re looking to find new dental and vision care through Medicare for 2021, now is the time.
To learn more about Priority Health’s Medicare offerings, visit our website or call our Medicare experts toll free at 888-481-1348. (TTY 711), 8 a.m. to 8 p.m. 7 days a week.