What Is Medicare Dental and Vision Coverage?
Medicare is a federal health-care program open to Americans who are age 65 or older or have a disability or terminal illness. There are many components to comprehensive Medicare coverage, such as the following plans:
- Part A Medicare pays for hospital and inpatient services
- Part B Medicare pays for most clinical and outpatient services
- Part C Medicare or Medicare Advantage combines Parts A and B benefits into a private insurance plan
- Part D Medicare pays for certain prescription medications
While these plans pay for critical services like surgeries, doctors’ visits, hospice care, and necessary drugs, they do not often have benefits for dental and vision. Medicare does not usually see these services as medically necessary, except in certain circumstances.
This is not a new phenomenon; many of us pay for supplemental dental and vision coverage through our employer. Medicare dental and vision plans work in a similar way.
To get Medicare dental and vision coverage, you’ll need to sign up for a stand-alone plan that offers these benefits. Alternatively, you can enroll in a Medicare Advantage plan that has built-in dental and vision coverage.
Medicare Dental Coverage
Medicare does not see dental services as medically necessary. As a result, this coverage does not usually pay for routine dental services, like cleanings or dental exams. If you have a dental problem while in the hospital or need dental work to prepare for treatment, Medicare Part A may provide some benefits:
- If you are preparing for radiation treatment and your medical team needs to remove a tooth to administer the treatment, your coverage will pay for the cost of the extraction.
- If you visit the emergency room with severe injuries to your mouth or teeth, Part A may provide limited coverage to treat this damage.
For preventive dental care and routine services, you will need to purchase a separate Medicare dental plan. Luckily, there are many plans available that can help close these critical gaps in coverage.
What Does Dental Coverage Cover?
Private insurance companies administer Medicare dental coverage, often as an addition to their Medicare Advantage plans. These providers may also offer supplemental dental plans that you can purchase separately.
Medical dental benefits vary from provider to provider. Most plans pay for the following services:
- Routine exams and cleanings
- Dental implants
- Crowns and bridges
- Treatment for gum disease
- Tooth extractions
- Root canals
- Cavity fillings
Original Medicare, a.k.a. Medicare Parts A and B, does not cover these services. If you require dental care, you are responsible for paying 100% of the cost. This can get very expensive, especially if you go to the dentist a lot.
With a Medicare dental plan, you could reduce a substantial portion of your out-of-pocket costs. Many plans offer 100% coverage for exams and cleanings and a small co-pay for other services.
Of course, dental plans are not the best option for everyone. If you don’t see a dentist that often and are in good oral health, your premiums and co-pays might outweigh your out-of-pocket costs.
Your agent from Sunnyside Medicare can help you find out whether dental coverage is right for you. We’ll compare the prices of different dental plans and carefully assess your health needs, helping you pick the most cost-effective option.
Medicare Vision Coverage
Like dental services, Medicare does not usually see vision care as medically necessary. If you only have Original Medicare, you will not receive coverage for eyeglasses, contacts, exams, or other services.
However, Medicare Part B does cover the following services:
- Glaucoma tests
- Preventive or diagnostic eye exams
- Exams to test for diabetic retinopathy
- Exams to test for macular degeneration
Medicare Part A may also pay for surgery if you have cataracts, as well as eye prostheses under certain circumstances. For example, if you lose your eye due to an accident, you may receive benefits for the initial prosthetic, as well as polishing and replacements every five years.
If you want coverage for eye exams and other routine services, you will need to invest in a separate vision plan. Like dental services, insurers offer vision coverage as a stand-alone supplement or as part of a Medicare Advantage plan.
What Does Vision Coverage Cover?
There are many types of Medicare vision plans available to Michigan residents. While your benefits will vary depending on your plan and provider, many insurers pay for the following services:
- Routine eye exams
- Preventive eye exams
- Eyeglass and contact lenses
- Coverage at specific retailers
- Eyeglass frames, including upgraded styles
Depending on your needs, these services can cost hundreds of dollars out of pocket. If you only have Original Medicare, you’ll be responsible for 100% of any noncovered vision services that you receive.
In these situations, supplemental vision coverage can significantly limit your out-of-pocket costs. This is especially true if you require frequent eye exams or wear contacts or glasses on a regular basis.
Does Medicare Supplement Cover Dental and Vision?
Medicare supplement plans, also known as Medigap, are an optional form of health-care coverage. These plans work alongside Original Medicare to cover costs that you may otherwise pay out of pocket, such as deductibles and co-pays.
There are 11 distinct Medigap plans available to Michigan residents, each with their own benefits. However, Medicare supplement plans do not cover dental or vision services.
If you would like to learn more about Medicare supplement coverage, check out our experts’ guide to Medigap here.
Contact the Medicare Experts at Sunnyside Today
Medicare dental and vision coverage is only one component of your health-care plan. When it comes to these services, different levels of coverage work for different people. You may not require vision services at all but need extensive dental care and vice versa.
The landscape can be very complex, and it can be difficult to find the best plans, premiums, and information. In these situations, it’s important to work with a licensed broker who can help you find the right coverage.
If you are enrolling in a Medicare plan, you need an expert on your side. At Sunnyside Medicare, our licensed agents can guide you through your options for free and build a custom plan that fits your unique needs.
If you’re enrolling in Medicare, you might as well get help from the best. Contact Sunnyside Medicare at (248) 277-5948 and discuss your options with one of our licensed agents.
Looking for a Helping Hand?
Call us at 1-248-277-5948 to talk with a Sunnyside Agent. Our licensed Medicare Agents are friendly, knowledgeable and always willing to take the time to find the right plan for you! Not ready to talk on the phone? Send us an online message and an Agent will get back to you shortly. We look forward to helping you.