Vision, Dental, and Medicare: What is Covered?

Older couple looking over paperwork of what is covered with their dental insurance

A commonly asked question is: will Medicare cover vision and dental? After all, the world of medical insurance can be confusing! To help, we’ve compiled some handy information that you can use to be sure every aspect of your health care needs are covered.

First Up, Is Dental Care Covered by Medicare?

Medicare is a little disappointing when it comes to covering dental care. If you need to see the dentist for anything like a checkup, cleaning, cavity filling, or extraction, or for things like dentures, implants, and bridges, it won’t cover you. What it might cover, however, is certain types of dental care you receive while you’re in a hospital as an inpatient.

The problem is that seeing your dentist on a regular basis as you get older becomes increasingly more important. Seniors may be at a greater risk of a wide range of oral health problems, and having your teeth, gums, and mouth checked by a professional can alert you to problems in their earliest stages, when they’re usually easier to treat.

What About Vision Care? Is It Covered by Medicare at All?

Like dental coverage, vision coverage is lacking under Original Medicare (Parts A and B), but receiving this care is really important, especially when you’re older. If you rely only on Medicare and you need a routine exam for your glasses or contacts, you’ll likely need to pay for it out of pocket unless you get additional coverage.

Part B might help with the costs of some tests and treatments related to certain eye and vision disorders. These might include tests to check for conditions like glaucoma and macular degeneration. Also, if you need surgery for cataracts, and corrective lenses following the procedure, or if you suffer from an eye injury, Medicare might help in those situations as well.

It Needs to Be Medically Necessary

Medicare Part A and Part B will typically only step in and help pay for care you receive when it’s deemed “medically necessary.” Because general dental and vision care isn’t considered medically necessary, things like your standard eye exam and dental exam, as well as certain services and treatments, won’t be covered.

In other words, Original Medicare usually won’t step in and help cover the cost of routine vision care and dental care. However, if you need to receive care that’s related to an emergency treatment or an underlying health problem, Medicare might step in. Follow-up care, though, may not be covered, so that’s important to keep in mind as well.

If you want Medicare to help with dental and vision care, you have the option of looking into Advantage (Part C) plans that may meet your needs. These are provided by private insurers, so coverage and costs will vary from one plan to the next, and it’s important to read the fine print to see just how far your coverage will go beyond routine care.

What’s the Solution?

To really know what’s covered and what’s not, carefully review the details of your Medicare plan. That way, you’ll know exactly what to expect, and you’ll know whether or not you need to purchase additional insurance.

If you want to be sure you’ll have peace of mind when it comes to dental and vision services that you need as a senior, don’t worry! There are standalone dental and vision plans, such as those offered by Spirit Dental and Spirit Vision. These are surprisingly affordable, yet they’re comprehensive and can cover everything from routine exams to corrective lenses for your eyes and a variety of oral health treatments for your teeth and gums.

Bottom line: The right standalone insurance plan can help you save a lot of money that you would otherwise be forced to spend out of pocket if you only relied on Medicare. And we all know how expensive dental and vision care can get!

Sources:

Medicare Coverage and What the Extra Coverage Is