Medicare usually does not cover dental, vision and hearing-related services. There are many options available for you to obtain this coverage. This article outlines the common DVH coverage options for Medicare enrollees..
Dental, Vision & Hearing coverage
Dental, vision and hearing (DVH) issues are common problems as you age. While Medicare Part A and Part B do not generally cover dental, vision and hearing related problems, many Medicare Advantage (MA) plans offer this as additional coverage.
Since DVH coverage is not regulated by Medicare, you are free to get this outside of the Medicare ecosystem, if you so desire.
Note that since DVH care is not a defined Medicare benefit, plans vary widely in their coverage and costs. Your plan's coverage may or may not be comprehensive enough for your needs. It is always a good idea to fully understand the DVH coverage offered by a plan, especially its limitations and exclusions. Sometimes MA plans offering DVH coverage may only offer a subset which may not suffice for your needs. So make sure you select a plan where this additional benefit meets your needs.
Medicare Advantage (MA) plans vary widely in their DVH coverage since it is a benefit not regulated by Medicare. Make sure you are aware of any exceptions and limitations imposed by your plan.
Medicare only covers dental issues while you are an inpatient at a hospital. Part A (hospital insurance) pays if you need to have emergency or complicated dental procedures while you are in a hospital.
Medicare Advantage (MA) plans may offer dental coverage including routine exams and cleanings, mouth-X-rays, fillings, crowns, oral surgery, endodontics, periodontics, implants, dentures and bridges or a subset of these benefits. You may have to pay coinsurance and there may also be a limit on benefits per calendar year. Make sure you are aware of such restrictions or limitations.
Medicare does not cover vision care, including routine eye examinations for prescribing eyeglasses or contact lenses. But if you have diabetes and need an yearly eye exam, it may be covered by Part B (medical insurance). Glaucoma patients may be eligible for glaucoma tests and cataract surgery.
Medicare Advantage (MA) plans may offer vision coverage including eye exams, glasses, frames and contact lenses or a subset of these benefits. You may have to pay coinsurance or copays and there may also be a limit on benefits per calendar year. Make sure you are aware of such restrictions or limitations.
Part B only covers hearing and balance exams for diagnostic purposes if your healthcare provider orders these tests. Medicare doesn't cover hearing exams, hearing aids or exams for the purpose of fitting hearing aids.
Medicare Advantage (MA) plans may offer hearing coverage including routine hearing exams and hearing aids. You may have to pay coinsurance or copays and there may be a limit on benefits per calendar year. Make sure you are aware of such restrictions or limitations.
Enrollment & Costs
You have many options for obtaining dental, vision and hearing coverage.
You can opt to go for a Medicare Advantage plan which offers DVH coverage, usually for an additional premium per month and other out-of-pocket costs. Some MA plans also allow you to add DVH coverage later as an opt-in benefit.
Carriers sometimes offer DVH coverage at a discount to their Medicare Advantage or Medicare Supplement customers. You may be able to add this to your existing coverage without linking them together.
As mentioned above, you are free to go outside the Medicare ecosystem to get dental, vision and/or hearing coverage. This is not a defined Medicare benefit so you can get it from any source.
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Last Updated: 01-10-2021