Does Medicare cover dental and vision services?
Are dental and vision services included in any Medicare plans?
Original Medicare (Parts A and B) generally does not cover routine dental and vision services, such as cleanings, exams, eyeglasses, or dentures. However, you do have options for obtaining dental and vision coverage through other Medicare plans. Here’s a breakdown of what’s available:
1. Medicare Advantage Plans (Part C):
Many Medicare Advantage (Part C) plans offer additional benefits beyond what Original Medicare covers, including dental and vision services. These plans are provided by private insurance companies and bundle Medicare Part A (hospital insurance), Part B (medical insurance), and often Part D prescription drug coverage, along with extra benefits.
Dental Coverage: Medicare Advantage plans commonly include dental benefits, which may cover:
Routine dental exams.
Cleanings.
X-rays.
Fillings.
Extractions.
Some plans may even offer coverage for more advanced procedures, such as root canals, dentures, and crowns.
Vision Coverage: Vision benefits offered by Medicare Advantage plans may include:
Routine eye exams.
Prescription eyeglasses or contact lenses.
Discounts on corrective lenses.
Some plans may also cover cataract surgery and provide coverage for intraocular lenses.
The extent of dental and vision coverage varies by plan, so it’s essential to compare plans to find one that meets your needs.
2. Standalone Dental and Vision Plans:
If your Medicare Advantage plan does not offer adequate dental or vision coverage, or if you have Original Medicare, you can purchase standalone dental and vision insurance through private insurance companies. These plans are separate from Medicare and provide coverage for services like routine exams, eyeglasses, and dental care.
3. Medigap (Medicare Supplement) Plans:
Medicare Supplement (Medigap) plans, which are designed to help cover the out-of-pocket costs of Original Medicare (like deductibles and coinsurance), do not include dental or vision coverage. If you have a Medigap plan and need dental or vision services, you’ll need to either purchase standalone coverage or pay out of pocket for these services.
4. Medicare Coverage for Certain Medical Dental and Vision Procedures:
While routine care is not covered, Original Medicare may cover certain dental or vision services if they are medically necessary due to a specific health condition:
Dental Procedures: Medicare may cover dental services if they are required as part of a covered medical procedure, such as:
Dental exams before a kidney transplant or heart valve replacement surgery.
Reconstruction of the jaw following an accident or disease.
Vision Procedures: Medicare Part B covers:
Cataract surgery, including the cost of intraocular lenses.
Glaucoma screenings if you’re at high risk.
Diabetic retinopathy screenings if you have diabetes.
Treatment for macular degeneration.
5. Medicare Part D and Vision-Related Medications:
If you need medications for a vision-related condition, such as glaucoma or macular degeneration, these may be covered under a Medicare Part D prescription drug plan. However, this coverage is separate from any routine vision care services.
Key Takeaways:
Original Medicare does not cover routine dental or vision care.
Many Medicare Advantage plans offer dental and vision benefits, covering routine services such as cleanings, exams, eyeglasses, and some dental procedures.
If you want dental and vision coverage, consider enrolling in a Medicare Advantage plan that includes these benefits or purchasing standalone insurance.
For help finding a Medicare plan that includes dental and vision coverage, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
