Most of us think of Medicare as comprehensive insurance, much like the group insurance plans we’ve been used to.
Like group insurance; Medicare is a collective of individual components designed to cover all of your basic healthcare needs, save two important pieces. Dental, hearing, and vision coverage are not part of Medicare’s grand design.
But before you make a decision based on dental, vision or hearing, make sure you do your research to ensure it makes sense.
It is best to consult with a licensed insurance agent, or research the plan in detail so you aren’t tricked into a plan that overall doesn’t fit you.
Having these extra coverage does not mean that a particular plan is in your best interest.
Medicare does cover yearly eye exams for annual glaucoma checks, people with diabetic retinopathy, and those with macular degeneration. These types of tests are only covered if the provider is an ophthalmologist that accepts Medicare assignment. Any routine eye exams, frames, lenses, or contacts are the responsibility of the patient.
Despite being an integral part of one’s health, Dental care is almost completely overlooked. Medicare will only cover dental care in the event of an emergency. For example, if you were being seen in the emergency room for a severely impacted tooth that required immediate extraction. Preventative care and maintenance are not covered at all.
Diagnostic hearing and balance testing are covered in the event your physician believes these tests are needed to determine if further medical treatment is necessary. Standard hearing tests, hearing aids, and tests used to fits hearing aids are not covered by Medicare.
Some Medicare Advantage plans offer vision, dental, and hearing insurance as “added benefits” to their plans.
This can cause some confusion for those Medicare Beneficiaries who remain in Original/Traditional Medicare. Before you have a procedure, you should verify your Medicare Advantage plan is accepted by your provider. Even though it covers services, it is still taken on a case-by-case basis and you may be responsible for 100% of the cost if your provider is out-of-network.
Traditional Medicare allows you to individualize each component of your insurance package.
This means you can go to individual insurance companies and buy coverage for each of these services. You may not feel the need for hearing insurance, or feel confident that you could self-insure an annual eye exam and a new pair of glasses. Therefore, you may only want to carry dental insurance.
Should you choose a Medicare Advantage plan that includes coverage for dental, vision, and hearing you may want to bear in mind that this type of plan may not be accepted by your primary care physician. You may also need referrals to be seen by specialists, and there are often underlying maximum out-of-pocket costs.
It is best to evaluate your personal insurance needs and determine the amount of coverage your feel comfortable with.
Don’t be tricked to buy a plan that doesn’t fit you just because it has dental, vision or hearing coverage. There are many more important things to base your decision on to ensure you don’t later regret your plan.
