Mike – Tex.: I will turn 65 next year and understand Medicare does not cover vision, hearing and dental needs. How would you suggest Medicare recipients cover these requirements?
Phil Moeller: Mike highlights one of the major missing pieces of basic (often called original) Medicare coverage. This is a big deal. The failure to get regular care in any of these areas can lead to serious health issues in later life that could cost a lot of money, not to mention reducing the quality of life in those later years.
Adding such coverage has been a major “in or out” issue in ongoing Democrat negotiations over provisions of President Biden’s “Build Back Better” legislation.
As is often noted, most private Medicare Advantage Plans provide some vision, hearing, and dental needs. However, this does not mean that original Medicare provides zero coverage. Here are the rules.
Parts A and B of Medicare will cover some surgeries involving these needs but not routine and ongoing care.
Medicare doesn’t cover routine eye exams (sometimes called “eye refractions”) for eyeglasses or contact lenses. Medicare Part B covers some surgical, preventive and diagnostic eye exams:
- Yearly eye exam but only for those with diabetes.
- Glaucoma tests for people at high risk for glaucoma.
- Macular degeneration for those with this condition.
- Cataract surgery (including a pair of corrective lenses if required after surgery).
Medicare Part B covers diagnostic hearing and balance exams if your doctor or other health care provider orders these tests to see if you need medical treatment.
Medicare doesn’t cover hearing exams, hearing aids or exams for fitting hearing aids.
Medicare doesn’t cover most dental care, dental procedures or supplies, like cleanings, fillings, tooth extractions, dentures, dental plates or other dental devices. Medicare Part A (hospital insurance) will pay for certain dental services that you get when you’re in a hospital. Part A can pay for inpatient hospital care if you need to have emergency or complicated dental procedures even though the dental care isn’t covered.
In the summer of 2022, Medicare’s parent agency, the Centers for Medicare & Medicaid Services, announced what could be an improvement in original Medicare’s coverage of dental work linked to other covered surgeries and medical conditions.