If you’ve ever had a toothache, you know just how frustrating and disruptive it can be. Suddenly decisions about what to eat – and even what to drink – take on much greater importance. Life becomes less enjoyable till you’re able to get the problem diagnosed and eventually fixed.
But what happens if it’s an expensive procedure? One that’s not covered by your health plan? Or what if a different health crisis arises, one impacting your vision or hearing? Each of these will have a profound impact on your day-to-day life and likely your bank account. This is why it’s so important to choose a Medicare plan that will give you the support you need.
Types of Medicare Coverage
Before we dive deeper into Medicare benefits, let’s take a quick look at the types of Medicare plans available.
Medicare Part A – This insurance covers inpatient care at hospitals, skilled nursing facilities, and hospice care. It’s known as hospital insurance.
Medicare Part B – This insurance covers preventive care, certain doctors’ treatments, outpatient services, and medical supplies. It’s basically medical insurance.
(Note: Medicare Parts A and B together are known as Original Medicare.)
Medicare Part C – This insurance is also called Medicare Advantage. Not only does it bundle together Medicare Part A and Part B, but it will often include Part D and bonus benefits Original Medicare does not. These can range from vision and hearing to dental and more. Medicare Advantage is offered by private organizations under Medicare’s supervision and must adhere to Medicare’s coverage rules.
Medicare Part D – This insurance offers coverage for approved prescription drugs, vaccines, and shots. This plan may be added to Original Medicare or a Medicare Advantage plan.
Now that you know the types of Medicare plans available, let’s see how they address three key healthcare needs.
Why Dental Care Is Critical for Seniors
While everyone needs routine cleanings and checkups for good oral health, these become even more important as we age. Not only do we have the wear and tear of decades of chewing on our teeth and prior dental work, but our gums recede over time as well, exposing unprotected tissue to decay.
There are also potential side effects from medications, such as dry mouth, which can lead to tooth decay and gum disease. And arthritis can turn brushing and flossing into a painful experience. But neglecting our teeth is not an option, because infections in the mouth can spread to other parts of the body and become life-threatening. Since quality dental care is essential, the next step is to make sure you can afford it.
Does Medicare Cover Dental?
Original Medicare’s coverage is extremely limited when it comes to dental. Medicare Part A will pay for hospital-related costs if you require an emergency or complex dental procedure in a hospital setting. However, just about all other dental care is not covered. So you will have to pay for routine cleanings, exams, crowns, dentures, etc. out of pocket.
If you would prefer dental included as part of your Medicare coverage, then a Medicare Advantage plan is your best solution. Depending upon the specific plan, the following items may be included:
- Diagnostic and routine dental care;
- Fillings, crowns, dentures, and other restorative measures;
- Endodontic procedures such as root canals;
- Oral surgeries;
Since the coverages and dollar amounts vary among the different Medicare Advantage plans, be sure to compare and choose the comprehensive Medicare dental coverage that’s best for you.
Does Medicare Cover Vision?
Much like with dental coverage, Original Medicare provides vision coverage under very narrow circumstances. If you want coverage for routine care, eyeglasses, and contact lenses, choosing the right Medicare Advantage plan is likely your best option.
Let’s take a closer look at a few of the vision-related needs that most commonly arise among seniors.
Routine Vision Care & Screenings
Original Medicare does not cover routine eye exams for glasses or contact lenses. However, Medicare Part B will pay for one preventative screening annually if you fall into the high-risk category for glaucoma. Some Medicare Advantage plans offer coverage for regular vision exams.
Cataract Surgery
Original Medicare and Medicare Advantage each cover the cost of cataract surgery. And Medicare Part B will pay for one pair of contact lenses, glasses, or intraocular lenses post-surgery to assist with your vision correction post-procedure.
Contact Lenses, Eyeglasses, and Intraocular Lenses
Depending on the Medicare Advantage plan you choose, all of these items could be covered. Under Original Medicare, only one of these items is covered and that’s immediately after cataract surgery.
Macular Degeneration
Over time, some seniors find that the central part of their field of vision deteriorates while the areas around the edges remain intact. Both Medicare Part B and Medicare Advantage may offer coverage for the medical services and medications required to identify and treat this disease.
The Bottom Line on Vision
Medicare Part A will only cover vision care if inpatient hospitalization is required to address your eye’s issue(s). When Medicare Part B provides coverage, it pays 80% of the medicare-approved amounts for those items. And you must use a medicare-approved provider/supplier to receive that coverage.
Some Medicare Advantage plans offer broader vision coverage, include specific dollar amounts to assist with purchasing eyewear and contact lenses. If vision coverage is important to you, then check out the Medicare Advantage eye care options available.
Hearing Loss in Seniors
According to the National Institute on Aging, about one-third of those aged 65 to 74 have hearing loss. And after age 75, almost fifty percent have issues with hearing. This can range from having difficulty hearing conversations, including doctor instructions, to noticing fire alarms and doorbells.
Because hearing loss can occur gradually with age, individuals may not be aware it’s happening. They may be embarrassed to admit there is a problem. While some seniors may respond by withdrawing from social interactions, others are mistakenly thought to be uncooperative or disoriented. This can have a profound impact on every aspect of day-to-day life.
Does Medicare Cover Hearing Aids?
Medicare Part B may cover the initial physician’s appointment to diagnose a hearing problem if your doctor deems it necessary. However, Original Medicare does not provide any coverage for hearing aids or the medical appointments necessary to fit and adjust them, so you will have to pay 100% of the cost.
Some Medicare Advantage Plans include hearing aids, batteries, and supporting appointments in their coverage. Because hearing aids can cost from one to several thousands of dollars, this could have a huge impact on your finances. If you expect to need hearing aids, then be sure to examine the Medicare Advantage plans available to you. Find out the dollar amounts offered for hearing aids and batteries, so you can choose the best plan for your needs.