Dental and vision care if something that most people need, increasingly, as they get older and are Medicare-eligible. As such, this is a very common question for people going on Medicare or already on Medicare – what, if anything, does Medicare cover as far as dental or vision?
Simply put, Medicare does not typically cover routine dental or vision. Medicare will not cover dental care that you need for the primary care of your teeth. It does not cover routine check-ups, crowns, extractions, cleanings, etc. Likewise, because “original” Medicare (Parts A & B) do not cover these services, your Medicare Supplement plan, if you have one, will not cover them either. Medicare Supplements (Medigap) always “follow” Medicare, filling in the “gaps” that are left over. So if Medicare doesn’t cover something, the supplement plan will not cover it. This applies to routine dental care.
So, what dental services will Medicare cover? It does cover some limited dental services, primarily in instances where they are required to protect your general health or for another covered procedure to be successful. Here are a few examples of dental services that Medicare does cover:
- You have a disease that affects the jaw (like oral cancer) and need dental services that are necessary for radiation treatment.
- You had a facial tumor removed and had ridge reconstruction as part of that particular procedure.
- You need surgery to treat fractures of the jaw or face.
- You need dental splints or wiring as a result of jaw surgery.
Medicare will pay for these initial services; however, Medicare will not pay for any follow-up care even in the above instances. So, as you can see, the coverage for dental services with Medicare is very limited.
As far as vision services, the Medicare coverage is likewise limited. Medicare does not cover routine eye care, such as check-ups. However, if you have a chronic eye condition, such as cataracts or glaucoma, Medicare will provide coverage. Medicare covers:
- Surgical procedures to repair the eye when you have cataracts or glaucoma
- Eyeglasses or contacts when you have one of these conditions.
- An eye exam to diagnose potential serious vision problems (i.e. an underlying issue that would reflect a serious eye condition)
So, overall, Medicare’s coverage of dental and vision is extremely limited. The majority of people on Medicare choose to self-pay for these routine services that Medicare does not cover. However, some people do elect to get separate dental/vision plans (separate from Medicare Supplement plans) that will cover these routine services. If you have questions about dental/vision insurance or Medigap plans, you can contact us on our website – http://medicare-supplement.us – or by calling us at 877.506.3378.