Medicare is a federally funded health insurance program for seniors 65 and older. It covers a wide range of medical services, including hospitalization, doctor visits, and prescription drugs. However, many people wonder whether Medicare also covers dental and Vision insurance.
The short answer is no; Medicare generally does not cover routine dental or Vision coverage. However, there are some exceptions and options to consider.
Dental Coverage under Medicare
Original Medicare, which includes Part A and Part B, typically does not cover routine dental care such as cleanings, fillings, dentures, and extractions. However, there are certain exceptions to this rule.
In some cases, Medicare may cover dental services related to specific medical treatments covered by the plan. For example, an oral exam and dental treatment may be covered beforehand if you need to undergo a heart valve replacement or a bone marrow, organ, or kidney transplant.
Similarly, a dental procedure such as tooth extraction may be covered if you have a mouth infection and require cancer treatment services like chemotherapy. Additionally, Medicare may provide coverage for any complications related to head and neck cancer treatment services.
What is the Cost of Dental service under Original Medicare?
Non-covered services, including most dental procedures, will require you to pay the full cost.
For inpatient hospital stays that are covered under Part A, the following applies for each benefit period:
- Days 1-60: A deductible of $1,632 applies.
- Days 61-90: A daily fee of $408 applies.
- Days 91 and beyond: A daily fee of $816 applies while using your 60 lifetime reserve days.
- After using all of your lifetime reserve days, you will be responsible for all costs.
For dental services that are covered under Part B, the following applies:
- After meeting the Part B deductible, you must pay 20% of the Medicare-approved amount.
- If you receive the covered service in a dentist’s office or another outpatient setting, you must also pay a copayment to the facility.
Vision Coverage under Medicare
Similarly, Original Medicare does not cover routine vision care, such as eye exams, eyeglasses, or contact lenses.
It’s worth noting that Medicare does cover certain eye conditions and treatments, such as cataract surgery and medically necessary eye exams. However, routine eye exams and eyeglasses are not typically covered.
What is the Cost of Vision Coverage under Original Medicare?
You have to pay the entire cost for services that are not covered, including most eyeglasses or contact lenses.
After you fulfill the Part B deductible, you will be responsible for paying 20% of the Medicare-Approved Amount for corrective lenses following each cataract surgery with an intraocular lens. If you opt for upgraded frames, you must pay for any additional costs.
It is important to note that Medicare will only cover eyeglasses or contact lenses purchased from a supplier enrolled in Medicare, regardless of who submits the claim.
Does Medicare Advantage cover dental and Vision care?
Medicare Advantage Plans offer all the benefits of Part A and Part B. These plans are private alternatives to Original Medicare and usually include dental and Vision services. Dental coverage can vary from plan to plan, but most Medicare Advantage plans cover preventive services such as cleanings and X-rays at no additional cost.
Takeaway
Dental and vision coverage are not included in Original Medicare (Part A and Part B). This means that routine dental check-ups, cleanings, fillings, and other dental services and routine eye exams, glasses, and contact lenses are not covered. However, there are some exceptions and options available. Certain dental services related to specific medical treatments may be covered, and some Medicare Advantage Plans offer dental and vision services.You can always consult our experts at Skyline Benefit if you have any questions regarding Medicare.
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