Compare Dental, Vision, & Hearing Policies

Dental insurance is often overlooked by both clients and agents, despite the cost of dental care.

• Basic dental services like cleanings and X-rays cost several hundred dollars.
• Major services like bridges and dentures cost several thousand dollars.
• One hearing aid can cost $2,000 to $3,000 or more.
• You can help Medicare clients keep those costs manageable with a DVH plan.

What does Original Medicare cover for Dental, Vision, and Hearing?

• Medicare Part A and Part B (known as Original Medicare) have minimal coverage for Dental, Vision, and Hearing.

Vision

Covered by Medicare

 Annual eye exams for people with diabetes.
 Corrective procedures for chronic eye conditions. For example, the removal of a cataract and replacement of the natural lens with a fabricated intraocular lens.
 Eyeglasses or contacts following the replacement of an intraocular lens.
 Eye exam to diagnose potential vision problems.
 An annual eye exam for those at high risk of glaucoma. Risk factors include:
     -  Diabetes.
     -  A family history of glaucoma.
     -  African-American and age 50+.
     -  Hispanic-American and age 65+.

Not Covered by Medicare

 Eye examinations related to prescribing glasses or contacts, with some exceptions.
 Eyeglasses or contact lenses (unless prescribed following cataract surgery).

Dental

Covered by Medicare

 Reconstruction related to jaw injuries.
 Dental exam required before certain procedures, such as heart valve replacement or kidney transplant.
 An emergency or complicated dental procedure that requires a hospital stay.
 Reconstruction following removal of a facial tumor.
 In most of these cases, Medicare will cover the procedure, but not follow-up visits.

Not Covered by Medicare

 Routine care such as cleanings and checkups.
 Fillings, crowns, or tooth extractions.
 Dentures, dental plates, bridges, or other dental devices.

Hearing

Covered by Medicare

 Hearing exam for a recent hearing loss due to illness or injury.

Not Covered by Medicare

 Routine hearing exams.
 Hearing aids.
 Examination for prescribing or fitting hearing aids.

To see our pick for DVH plans, download 5 Best Medicare Ancillary Products for Financial Peace.

Other DVH Options for Your Clients

Medicare Advantage

While Original Medicare doesn’t cover most needs related to DVH, many Medicare Advantage plans do. If a client has significant DVH needs, a Medicare Advantage plan may be a better fit than Original Medicare plus a DVH policy.

Medicaid and D-SNPs

In some states, Medicaid covers dental services, optometry services, dentures, and eyeglasses. If your client can qualify for Medicaid, they’re eligible for those services. If they qualify for both Medicaid and Medicare, they may qualify for a Dual-eligible Special Needs Plan (D-SNP). Depending on the particular plan, D-SNP plans may cover:

 The cost of Medicare Part B (and part A, in some cases).
 At state option, certain premiums charged by Medicare Advantage plans.
 Original Medicare deductibles, coinsurance, and copayments (except for nominal copayments in Part D, the Medicare drug program).

To learn more, get a copy of our free Guide to Selling D-SNPs.