woman shopping for glasses
scott@ksmedigap.com No Comments

Your Part A and Part B will NOT pay for your eyeglasses, dentures or hearing aids. However, your supplemental insurance might. It depends on which plan you choose.

Medicare doesn’t cover everything…

Medicare doesn’t cover your eyeglasses, contacts or the exam related to prescribing glasses. It also doesn’t cover dentures or routine dental cleanings and x-rays. In addition, routine hearing exams and hearing aids are not covered.

How do I get dental, vision and hearing coverage?

The way you get dental, vision and hearing coverage will depend on how you choose to fill in the gaps of Medicare. Your two choices to fill in the gaps of Medicare are:

  1. Medicare Supplement (Medigap) – If you choose a Medigap plan you will need to get a separate insurance policy for dental, vision and hearing coverage. These policies range in price from $35-$60/month.
  2. Medicare Advantage – If you choose a Medicare Advantage plan then you will have dental, vision and hearing coverage included in your plan.

Medigap + Dental, Vision and Hearing policy

A Medigap plan offers the most coverage and freedom when it comes to filling in the gaps of Medicare. However, your Medigap plan only goes where Medicare goes. So just like Medicare, Medigap doesn’t cover routine dental, vision and hearing, which means you’ll need a separate insurance policy for these needs. These stand alone policies are generally set up like this:

  • Annual deductible (usually around $100)
  • Tiered coverage – For example, during the first year the insurance company will pay 60% of your bill; second year – 70%; year 3 and thereafter – 80%.
  • Waiting periods – There is usually a waiting period for the more expensive procedures – eyeglasses/contacts, dentures and hearing aids.
  • In-network discounts – Although some plans let you see any provider, it is usually best financially to see an in-network provider.

Medicare Advantage – includes Dental, Vision and Hearing

Medicare Advantage plans are another way to fill in the gaps of Medicare. However, it is much different from a Medigap plan. A Medicare Advantage plan actually replaces your Medicare. So you will receive all of your healthcare from the private Medicare Advantage insurer.

Medicare Advantage plans include routine dental, vision and hearing insurance. The coverage is usually structured as follows:

  • You might get $1000 per year towards comprehensive dental coverage. So your cleanings may have a $0 copay and then you will get $1000 towards things like extractions, fillings and dentures.
  • Your vision coverage may include $150 every two years towards eyeglasses or contacts.
  • Your hearing coverage may be structured as various copays for different level hearing aids.

One last option for Dental, Vision and Hearing insurance…

For those people that have a Medigap plan, you have one more option for your dental, vision and hearing insurance – and that is self-insuring. Self-insuring means setting aside some money each month in anticipation of your next dental cleaning or a new pair of glasses. Then you tell your provider you would like the cash price for the service because you don’t have insurance. Some folks find this suits them best because they don’t find a lot of value in a separate policy for dental, vision and hearing.