Everything To Know About Medicare Dental, Vision, And Hearing Coverage

Medical insurance is an essential thing to have to ensure you receive quality healthcare even during emergencies. Medicare is health insurance provided by the federal government primarily for people above 65 years old.

It also helps certain people under 65 years with disabilities or with final-stage renal disease requiring a transplant or dialysis, sometimes called ESRD.

It comes in different parts, offering different coverage. Therefore, you need to determine what each part covers before applying.

Medicare Vision Coverage

In many cases, Original Medicare does not cover your routine eye care services like eye examinations, screenings, contact lenses, and glasses.

However, Part B Medicare covers your annual eye examination from a state-authorized physician if you have diabetes to determine if you have diabetes-related vision issues.

It also covers the examination if you have a high risk of getting glaucoma. Doctors classify you as a high-risk glaucoma case if you have diabetes or a glaucoma family history and if you are above 50 years, African American, or Hispanic American.

Medicare also covers the following if you have a severe eye condition like glaucoma or cataracts.

A surgical procedure to help repair eye function, like removing a cataract or lens replacement surgery. Most times, doctors replace eye lenses with fabricated intraocular lenses.
Contact lenses or eyeglasses if the doctor placed an intraocular lens in the eye following a cataract surgery. Usually, Medicare covers standard, untinted prescription glasses or contacts. However, it might cover customized contacts or eyeglasses if they are medically necessary.
Eye examinations to diagnose potential chronic vision issues. The policy covers the examination even if the doctor finds no vision problem.

A Part B deductible applies when Medicare pays for any of these, meaning you will pay 20% of your Medicare-approved amount.

If you have medicare Advantage, you might get coverage for annual ro

Medicare Dental Coverage

Original Medicare does not cover your routine dental and oral health care needed to keep your gums and teeth healthy. That includes but is not limited to fillings, cleanings, tooth extractions, root canals, or dentures.

However, it may cover dental care required to protect your general health or a dental procedure needed before another healthcare service. Below are some dental services Medicare Original covers.

Oral examinations required before kidney transplants
Dental services before radiation treatments for jaw-related issues like oral cancer
Oral examinations in Federally Qualified Health Centers or rural clinics before heart valve replacements
Ridge reconstructions after removal of a facial tumor
Dental wiring and splints required after a jaw surgery
Surgery for treating fractures in the face or jaw

While the policy covers these initial dental services, they do not pay for follow-up dental care after treating your original condition.

Medicare also covers specific dental-related hospitalizations, like observations you might need during a dental procedure if you have a health-threatening condition. In such cases, the insurance covers the cost of hospitalization, like anesthesia, room and board, and x-rays.

However, it will not cover your dentist fee for the treatment or charges for other physicians like anesthesiologists or radiologists. While it will cover your inpatient hospital care, it will not cover dental services not included in Original Medicare coverage, like dentures.

If you want to cover additional dental services, consider taking Medicare Advantage or Part C. In addition to the basics covered by Original Medicare, some Medicare Advantage plans will cover your routine dental services.

This includes preventive dental care services like cleanings, oral exams, and x-rays. Some also offer comprehensive dental services like extractions, crowns, gum disease treatment, and fillings.

Routine eye exams plus an allowance to buy prescription eyewear. Ensure to ask what is included in your MA before applying.

Medicare Hearing Coverage

One of the most common questions people ask is if it covers dental, vision, and hearing care. The short answer is no. Original Medicare, Part A and B, do not cover any of the following. However, it may cover them in certain circumstances.

Original Medicare Part B does not cover hearing examinations or hearing aids. However, it usually covers hearing and balance examinations if the doctor needs them to diagnose other health conditions like dizziness.

However, it only pays for part of the cost because deductibles apply, meaning you will pay 20% of the Medicare-approved fee. You might also pay other expenses, especially if the exam happened in a hospital setting.

From the start of 2023, Medicare will cover your audiologist visit without a referral from your primary healthcare provider if your hearing or balance issue has lasted for over 12 months.

Medicare Advantage, however, might cover some routine hearing services and part of the costs for hearing aids.

Conclusion

Medicare is one of the best ways for people over 65 or those with disabilities to get health insurance without worrying about the high costs of private policies.

However, ensure you research what is covered by every part and to what extent. You should also check where deductibles apply to determine whether it is affordable in the long run.

Author Profile

Adam Regan

Deputy Editor

Features and account management. 3 years media experience. Previously covered features for online and print editions.

Email Adam@MarkMeets.com