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Medicare Ancillary Plans: Dental, Vision, and Hearing Coverage
Ancillary plans like dental, vision, and hearing coverage are just as important as your Medicare plan. Find out what Original Medicare covers to determine if you need an ancillary plan for retirement.
What Do Medicare Ancillary Plans Cover?
Medicare covers most major medical needs for people 65 and older, but some services fall outside the program’s scope. This gap often leads people to search the ancillary plan market for dental, vision, and hearing coverage.
To be clear, ancillary plans aren’t generally attached to any Medicare coverage but instead are standalone plans available on the private insurance market. They’re available to anyone, regardless of their Medicare status or eligibility.
Yet, there are times when Medicare does cover dental, vision, and hearing services, so it’s important for anyone considering their Medicare options to understand what kind of care they need before turning to ancillary plans and private coverage.
Let’s explore how Medicare does—or doesn’t—cover ancillary health services, and what options you have for getting the coverage you need.
Does Medicare Cover Dental?
Medicare covers dental care when it is an emergency, life-saving situation. For instance, if your dental situation has reached the point of infection and you’re risking death by avoiding treatment, then Medicare will cover your care.
Original Medicare will also cover dental care such as tooth extractions if it is a medically necessary part of treatment for another condition, like cancer. Granted, in these instances, you’ll still need to pay for any co-pays, co-insurance, or unpaid deductible.
Essentially, unless your dental care is part of a life-threatening condition, Original Medicare won’t cover it, and you’ll have to turn to either a Medicare Advantage plan or ancillary dental coverage.
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Book a free call by clicking below or if you are free now give us a call at: 800.8648890
Does Medicare Cover Vision Care?
Original Medicare vision coverage is more robust than other ancillary coverages. While the most common uses of vision care, such as exams for prescription eyewear and the cost of contacts or frames, aren’t covered, many surgeries are.
If you have diabetes, Medicare will cover a special eye exam to monitor for diabetic retinopathy once a year. Original Medicare also covers an annual screening if you have any factors that put you at higher risk of developing glaucoma or if you have macular degeneration.
Original Medicare also covers medically necessary surgeries, such as those that treat cataracts or glaucoma. Unfortunately, surgeries like LASIK are not covered since they are elective.
Any vision coverage under Original Medicare may still include the Part B deductible, co-pays, and a 20 percent coinsurance, depending on whether you have a Medicare Supplement plan to complement your Medicare coverage.
Many treatments for common eye diseases don’t involve surgery but rather are controlled with long-term medication. In these instances, you’ll want to ensure your Medicare Part D plan for prescriptions covers whatever vision prescriptions you need.
Does Medicare Cover Hearing Care and Hearing Aids?
Medicare doesn’t cover hearing aids, hearing exams, hearing aid fittings, or really any audiology services.
The reason that Original Medicare doesn’t cover hearing aids is because, while about 65 percent of Americans over 70 suffer from hearing loss, fewer than a third of the hard-of-hearing population use hearing aids. The National Institute of Health conducted a large, randomized study to test the link between hearing loss and cognitive decline. The results found that people who were at a higher risk of dementia and received hearing aids for their hearing loss had a nearly 50 percent reduction in the rate of their mental decline.
Medicare Coverage Options for Dental, Vision, and Hearing
Just because Medicare Parts A and B don’t cover dental, vision, and hearing care doesn’t mean that you should forego these services. Instead, it means looking outside Original Medicare for your ancillary care solutions.
Dental, vision, and hearing plans may not be wrapped into Original Medicare, but that certainly doesn’t mean forgoing the kind of preventative care that stops problems before they start. Instead, arm yourself with the knowledge to help make a decision that’s right for you.
1. Medicare Advantage Plans
Medicare Advantage plans, also called Part C, are private alternatives to Parts A and B. They typically have Part D prescription coverage and some ancillary dental, vision, and hearing benefits. Many people gravitate toward Medicare Advantage plans precisely because of these ancillary benefits.
Yet, the extent of Medicare Part C coverage for dental, vision, and hearing plans can vary a lot from plan to plan, so it’s important to consider the limitations of any plan you’re considering. For instance, a Medicare Advantage plan may limit hearing aid coverage to a single kind of hearing aid, which may not be useful if it’s not a type that fits you and your needs.
Advantage plans also operate based on coverage networks like standard private care plans. Because of this, you’ll want to confirm whether a particular plan covers your preferred optometrist or dentist as part of its network.
Whether you choose Original Medicare or Medicare Advantage, out-of-pocket spending will be far less for vision than for dental and hearing care for those who need it.
2. Self Payment for Dental, Vision, & Hearing Care
Another strategy Medicare recipients use to cover dental, vision, and hearing care is self-pay. This means forgoing insurance for the basics of these coverages and instead paying for preventative care out of your pocket.
This is a particularly popular way to handle vision care since most of the more extreme vision problems you might encounter are considered medically necessary and are covered under Medicare. Hearing care is also often paid for out of pocket, as the major cost for audiology visits is typically for the hearing aids themselves.
If you’re interested in paying for dental, hearing, or vision coverage entirely out-of-pocket, it pays to acquaint yourself with your potential costs upfront. For instance, research published by Kaiser Family Foundation (KFF) in 2021 noted the average out-of-pocket spending on dental services alone for Medicare beneficiaries of all kinds was $454 in the year they studied. Half of beneficiaries who used dental services paid about $874, and one in ten spent more than $2,000 out-of-pocket.
3. Medicare Ancillary Plans
Those with Original Medicare often cover their vision, hearing, and dental needs with ancillary plans. Ancillary plans provide coverage that is frequently outside the scope of regular health care—not just Medicare but employer-provided health care or individual plans, as well.
Ancillary plans for vision, dental, and hearing are open to any consumer looking for these specific kinds of coverage. You may be able to find one that bundles coverage, but it’s important to price them both together and independently to get the best pricing and coverage comparison.
Ancillary plans also often have pre-existing conditions exclusions, where you have to be on the plan for a certain amount of time before qualifying for coverage, such as waiting for six months before qualifying for a dental crown.
Find Dental, Vision, and Hearing Coverage at Medicare School
Deciding how to cover all your healthcare needs that might arise once you’re on Medicare is no small thing, and it’s easy to get overwhelmed. However, you don’t have to do it all on your own.
For a more in-depth look at your Medicare coverage for dental, vision, and hearing, enroll in our virtual Medicare workshop today and learn more. Or, if you’d like help that’s more specific to you and your needs, schedule some time to talk through your options with one of our Medicare guides or call now!
Medicare Dental, Vision, and Hearing Coverage FAQ
Does Medicare Cover Dental, Vision, and Hearing Care?
Original Medicare (Parts A & B) generally does not cover routine dental, vision, or hearing, but some Medicare Advantage plans may include these benefits.
What Do Medicare Ancillary Plans Cover?
Ancillary plans offer additional coverage for services not included in Original Medicare, such as dental, vision, hearing, and other supplemental benefits.
What Coverage Options Are Available for Dental, Vision, and Hearing?
Coverage options include Medicare Advantage plans with added benefits, standalone dental, vision, and hearing plans, private supplemental insurance, or self-payment options.