While Medicare provides health insurance for many medical necessities, it doesn’t cover everything. Dental, vision, and hearing care are excluded from Original Medicare and Medicare Supplement coverage. You will be responsible for paying for expenses such as dental fillings, routine exams, hearing aids, and eyeglasses. And these expenses can add up quickly. However, there are certain situations where Medicare beneficiaries may be covered for dental, vision, or hearing care.
Medicare doesn’t cover routine care such as bridges, oral exams, fillings, crowns, or cleanings. But there are a few exceptions:
- Medicare may cover dental services if they are an important part of another Medicare-approved procedure. For instance, if your jaw is hurt during an accident, Medicare may cover your jaw reconstruction if required to treat your injury.
- Medicare may also cover teeth extraction to prepare your jaw for radiation treatment for jaw-related diseases.
- Medicare may cover dental examinations before a complicated procedure that involves an oral exam. Original Medicare covers you, depending on whether the exam is done in an inpatient/outpatient setting.
Note: Some Medicare Part C (Medicare Advantage) plans may offer coverage that is beyond what is offered by Original Medicare, including dental, vision, and hearing coverage. However, Medicare Part C plans vary in terms of the benefits provided.
Medicare doesn’t offer hearing aids or exams coverage. You will be required to pay for all of the cost of hearing aids and exams. However, in a few cases, Medicare may cover hearing tests, but only if it is recommended by your Primary Care Physician. In other words, Medicare won’t cover your hearing tests without a referral.
Medicare Advantage, on the other hand, can cover your hearing care, including hearing aids.
Medicare provides limited vision care; it doesn’t cover fitting exams, eyeglasses, routine eye exams, and contact lenses. However, if you have cataract surgery, Medicare Part B will cover eyeglasses or a set of contact lenses. Part B will also pay for routine eye exams for Medicare beneficiaries who have diabetes to check for diabetic retinopathy. Part B also provides certain preventive care services such as annual glaucoma tests for high-risk beneficiaries. However, you have to pay 20% of the out-out-pocket cost and the deductible.
Medicare also covers tests and exams for diseases like dry eye syndrome and degeneration because they are considered medically necessary. Medicare also covers surgery like cataracts, which is considered medically necessary.
Those that enroll in Medicare Part C plans may have eyewear and regular eye exams under their coverage.
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