Dental, Vision, and Hearing Options for Medicare Insurance Plans
Maintaining your health goes beyond just working with your doctor, eating well, and exercising. You also want to maintain your teeth and gums, your vision, and your hearing. Original Medicare (Parts A and Part B) generally do not cover routine dental or vision services like cleanings, fillings, glasses, and hearing aids. You need to know your options!
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Dental Insurance Coverage Made Easy
Regular maintenance of teeth and gums is an important part of our overall health, but the rising costs of dental care may make it difficult to keep up with. That’s where dental insurance may help. Below are some considerations for choosing dental insurance.
Types of Dental Insurance Plans
- Preferred Provider Organization (PPO) Co-Insurance Plans – These plans typically pay a percentage of covered dental services. Sometimes there may be a small deductible (dollar amount you have to pay before the plan starts covering their portion of the dental service). These plans will have a maximum allowance, which means that once a policy pays out a certain dollar amount for the contract year, it will not pay for anything after that until the next contract year. Allowance amounts may be anywhere from $1,000 to $5,000 a year.
- Discount Plans – Instead of paying all or a portion of a dental service, these plans will discount each service and will let you know your responsibility upfront. For example, the plan contract will state that you are responsible for $10 for each office visit. This means that the discount plan will pay the provider everything above that amount. These plans typically do not have a maximum allowance.
- In-House Dental programs – Some dental offices have their own subscription programs that work as half insurance, half discount program. Meaning that for a monthly sum, two to three cleanings a year are covered and the program may provide additional discounts for major services.
Type of Services Covered
- Preventive and diagnostic dental care: This includes your cleanings, checkups, x-rays, and office visits. Almost all dental plans and dental insurance policies cover this level of care at 100%, usually with no waiting periods.
- Basic dental care and dental procedures: This includes minor dental procedures such as fillings, tooth extractions, fixing chipped teeth, and other such basic procedures. Plans will usually cover 80% of the bill, in most cases waiting periods may apply.
- Major dental care: This includes dentures, bridges, dental surgery, implants and other large, expensive dental procedures. Policies providing these benefits tend to be more expensive. Plans will usually cover 50% of the bill and, in most cases, waiting periods may apply.
Waiting Periods
Most dental insurance providers will impose a waiting period, meaning you will continue to pay your monthly premium but cannot use the benefits until the waiting period is over. Waiting periods are usually 6 to 12 months. Some dental policies will waive waiting periods based on prior coverage; in this case you will not have to wait for that service to be available to you.
Just like with other insurance, dental insurance needs to be chosen carefully to fit with the rest of your coverage. We can help you do that.
Learn About Vision Coverage Options
The first question you should ask yourself is, do you need vision coverage? Not everyone does.
There are three types of vision coverage:
- Eye exams – This is a routine eye exam usually done by an optician or optometrist in a retail vision center or slam clinic that usually also provides glasses and contacts. As most routine checkups are between $50 and $150 per exam, a vision policy is not always necessary if that is all you are looking to cover.
- Vision Hardware – This includes glasses and contacts. Most insurance companies will only cover one of those options per year, so you’ll need to choose whether glasses or contacts better fit your lifestyle. Most insurance plans will generally pay for lenses and add an extra allowance for frames. If you need glasses or contacts and like to get a new pair or set yearly, vision insurance may be the right option for you.
- Medical vision – This may include visits to an ophthalmologist or a vision specialist for medical conditions like glaucoma, cataracts, macular degeneration, refractive errors or diabetic retinopathy. This will also include non-cosmetic surgeries such as cataract surgery, eye injections and corneal transplantations. Medical vision services are typically covered by your medical policy and if that is the only type of coverage you are looking for, you may not need vision insurance by itself.
Are Hearing Aids Covered by Insurance?
Hearing is a crucial part of staying connected to the world, especially with your friends and family. And, just like your vision, hearing acuity tends to decline as you age. That means, you may need hearing aids at some point in your life.
Original Medicare (Part A and Part B) does not cover hearing aids or the exams for fitting and adjusting them. However, Medicare Part B may cover diagnostic hearing services if ordered by a doctor to treat a medical condition.
Hearing aids, and associated exams and other services, may cost hundreds to thousands of dollars. If you are concerned about hearing loss or anticipate needing hearing aids, ask My Medicare Solution about optional coverage that will help you.