Dental, Vision, and Hearing

What does it Cover?

Original Medicare only covers dental, vision, and hearing when it is related to inpatient or outpatient medical needs.

In each section, we will detail what Medicare covers and then what you will need to purchase additional coverage for, should you need it.

Should you need additional coverage, the good news is we can help!

Medicare and dental insurance

Medicare has very limited dental coverage that is only meant to protect your general health in order for another Medicare-covered health service to go smoothly.

It does not cover routine checkups, cleanings, fillings, dentures (full or partial), or most tooth extractions.

The only way you can gain this kind of coverage is through a Medicare Advantage plan that includes these benefits or through a standalone dental insurance plan.

Does Medicare include vision insurance?

In most cases, Original Medicare does not include coverage for routine eye exams, eyeglasses, or contact lenses.

One of the most common ways it will pay for them is following cataract surgery that implants an intraocular lens. Following that specific surgery, Medicare Part B will help pay for corrective lenses, one pair of eyeglasses or one set of contact lenses provided by an ophthalmologist.

However, the drawback is it will only offer this benefit once per lifetime and they only pay for a standard pair of eyeglasses. You would be responsible for the cost of upgraded frames.

Part B also covers a glaucoma screening every 12 months but only for people at high risk for it. This includes those with diabetes, people with a family history of glaucoma, African Americans who are 50 or older, and Hispanic Americans who are 65 or older.

Eye prostheses are covered for patients with absence or shrinkage of an eye due to birth defects, trauma or surgical removal. It also covers replacement, typically every five years.

Part B will cover certain diagnostic tests and treatment of diseases and conditions of the eye.

If you are wanting routine eye exams and more than one pair of eyeglasses or contact lenses (or better than the standard frames), an inexpensive standalone vision plan is likely your best bet. Some Medicare Advantage plans may include suitable coverage as well. However, you will need to consult a licensed Medicare insurance agent to discuss the plan’s details.

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How Medicare and hearing insurance coexist

If you only have Original Medicare, it does not cover hearing aids. Part B does cover some hearing tests, such as diagnostic hearing and balance exams. You will have to go through your primary care provider for your initial screenings. Once they recommend that you need additional treatment, your Part B coverage will pay for a portion of the costs.

Medicare Supplements can help some, but its coverage only triggers after Original Medicare pays first. So, unfortunately, it likely will not cover hearing aids either.

A standalone dental, vision, and hearing plan will help cover the costs of hearing aids and other services like routine exams. A Medicare Advantage plan with hearing benefits included may also offer coverage, but you will have to consult a licensed Medicare insurance agent regarding plan details.

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