Medicare is known for generous coverage when it comes to basic medical care costs. When it comes to coverage of dental, vision and hearing costs, however, it’s another matter.
In this week’s reader question, Phil Moeller, the author of Get What’s Yours for Medicare: Maximize Your Coverage, Minimize Your Costs and co-author of the updated edition of How to Get What’s Yours: The Revised Secrets to Maxing Out Your Social Security, explains exactly what benefits Medicare offers in those areas—and the best way to get more coverage.
Got a question of your own about Medicare or Social Security? Send it to [email protected].
Mike, Texas: I will turn 65 next year and understand Medicare does not cover vision, hearing and dental needs. How would you suggest Medicare recipients cover these requirements?
Phil Moeller: This question highlights one of the major missing pieces of basic Medicare coverage. And it’s a big deal. The failure to get regular care in any of these areas can lead to serious health issues in later life that could cost a lot of money, not to mention reducing the quality of life in those later years.
Parts A and B of Medicare will cover some surgeries involving these needs but not routine and ongoing care. Here are explanations from the agency’s website of what it does and doesn’t cover.
Medicare doesn’t cover routine eye exams (sometimes called “eye refractions”) for eyeglasses or contact lenses. Medicare Part B covers some surgical, preventive and diagnostic eye exams:
- Yearly eye exam but only for those with diabetes.
- Glaucoma tests for people at high risk for glaucoma.
- Macular degeneration for those with this condition.
- Cataract surgery (including a pair of corrective lenses if required after surgery).
Medicare Part B covers diagnostic hearing and balance exams if your doctor or other health care provider orders these tests to see if you need medical treatment.
Medicare doesn’t cover hearing exams, hearing aids or exams for fitting hearing aids.
Medicare doesn’t cover most dental care, dental procedures or supplies, like cleanings, fillings, tooth extractions, dentures, dental plates or other dental devices. Medicare Part A (hospital insurance) will pay for certain dental services that you get when you’re in a hospital. Part A can pay for inpatient hospital care if you need to have emergency or complicated dental procedures even though the dental care isn’t covered.
More options for coverage
Although basic Medicare does not cover these items, many Medicare Advantage plans do. So you may want to take a look at Medicare Advantage plans available where you live and look at their coverage of these items.
Many people like basic Medicare because it allows them great freedom in choosing their doctors, other care providers and hospitals. Medicare Advantage plans usually require their customers to use providers within the plan’s network or pay higher costs for out-of-network care. If basic Medicare is attractive to you, then you’d need to look elsewhere for your vision, hearing and dental insurance. There are private insurance plans outside of Medicare that will cover these items through separate insurance policies.
This may seem like a lot of work. But if you sit down at your computer and search for available policies, you can quickly get an idea of costs. You can also find an insurance broker who can quickly compare several policies for you and generate a quote for the coverage options you want.
These questions previously appeared on the PBS NewsHour Making Sen$e website.