Why do I need these plans? Doesn’t Medicare offer these benefits?
Original Medicare only covers dental, vision, and hearing when it is related to inpatient or outpatient medical necessity.
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. Medicare Supplements also will not cover these additional benefits.
On the other hand, certain Medicare Advantage plans will sometimes include additional dental benefits as part of their network based plan.
In most cases, Original Medicare does not include coverage for routine eye exams, eyeglasses, or contact lenses.
Normally Medicare will pay only if 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), then finding a stand-alone plan or one where vision benefits are included will be required.
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.
Ultimately what we have found works best is for our clients to enroll in a stand alone plan that combines the dental, vision and hearing benefits. The monthly premium is low and allows you to have more coverage than what you would normally be provided otherwise with just Original Medicare.