Medicare Supplemental Dental And Vision Insurance - Original Medicare (Parts A and B) helps pay for "medically necessary" care. This is only what is needed to treat the disease or condition.
Medicare does not consider dental care to be medically necessary. Original Medicare generally does not cover dental tests, procedures, or supplies. But Part A can help with certain dental services while you're in the hospital.
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Vision care is not considered medically necessary, so Original Medicare does not cover eye exams, glasses, or other vision-related services.
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However, Medicare Part B may cover some things related to vision, including preventive or diagnostic eye exams including glaucoma tests, annual eye exams to test for diabetic retinopathy and eye exams for macular degeneration, cataract surgery, and prescription lenses or glasses in certain circumstances.
But don't worry, you've got Medicare if you want some help with your dental and vision care. Watch the video below to learn how dental, vision and hearing care is covered when you choose Medicare.
In the details, a graphic of a toothbrush with toothpaste scattered on the bristles, a human ear and a poster with an eye examination appear side by side.
Two icons will appear. One of the hospital rooms was labeled "Medicare Part A." The second icon is a stethoscope and is labeled "Medicare Part B."
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Dentist, eye exam and human ear icons will appear. All three are marked with a red X.
Icons of a bottle of pills, a mobile phone with a stethoscope on the screen, a car, a medal, exercise equipment and a house with a plus sign marked on the side are displayed on a blue background.
NARRATOR: Many Medicare Advantage plans may also offer prescription drug coverage, telehealth, transportation benefits, healthy member rewards, fitness members and more.
The text appears above the stethoscope, pill bottle, heart, plus and H icons.
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NARRATOR: Please note that covered benefits and costs vary by plan and provider, so research your options carefully.
In addition to offering the same coverage as Original Medicare, Medicare Advantage plans (Part C) may also offer coverage for dental and vision care. Most also have prescription drug coverage and other benefits like hearing health coverage and gym memberships.
Medicare Advantage plans are offered by private insurance companies. The plans available to you depend on where you live. What specific dental and vision services are covered and how much they will cost will vary from plan to plan.
Use this simple tool to search and compare available Medicare plans with dental and vision coverage in your area. Just enter your zip code and the tool will generate a list of plans offered where you live.
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You can select the plans you want to learn and compare from the list. Get estimated annual costs and estimates for each plan to find the plan that will help meet your needs.
Insurance companies offering policies in your area will be able to provide you with more information and answer your questions. Just contact them directly.
Regular dental and vision examinations are important for maintaining overall health. It's important to explore your options and find a plan that provides the services you want and need.
Medicare, clearly brought to you by UnitedHealthcare, provides Medicare education so you can make informed decisions about your health and Medicare coverage. Meredith Freed. Meredith Freed Follow @meredith_freed on Twitter, Nancy Ochieng, Nolan Sroczynski, Anthony Damico and Krutika Amin Follow @KrutikaAmin on Twitter
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Dental benefits are generally not covered by Medicare, except in certain circumstances, and many Medicare have no dental coverage at all. Some Medicare beneficiaries have access to coverage through other dental sources, such as Medicare Advantage plans, but the range of dental benefits covered varies widely and is often very limited, which can lead to high out-of-pocket costs among those who have them. serious dental needs or unmet needs.
Policymakers are now considering ways to make dental care more affordable by expanding dental coverage for people on Medicare. President Biden's 2022 budget request includes "access to improving Medicare dental, hearing and vision coverage" as part of the president's health care agenda. Senate Democrats recently announced a deal to include Medicare expansions, including dental, vision and hearing, as part of a budget reconciliation package, though details of the deal have not yet been released. In 2019, the House Elijah E. Cummings Low Drug Costs Now Act (H.R.3) would add a dental benefit to Medicare, along with a vision and hearing benefit, in addition to reducing prescription drug costs. . This year, Representative Doggett, along with 76 members of the House of Representatives, introduced the Medicare Dental, Vision, and Hearing Benefits Act (H.R. 4311), which would cover these Medicare Part B benefits.
In light of these ongoing policy debates, this brief provides new data on the proportion of Medicare beneficiaries with dental coverage, attendance at dental visits in the past 12 months, and out-of-pocket expenses for dental care. There's also a closer look at the range of dental benefits that Medicare provided for each plan in 2021. The plans focus on the Medicare benefit as they have become the source of dental coverage among Medicare beneficiaries. Our analysis draws on multiple data sets, including the Medicare Current Beneficiary Survey for information on dental and outpatient dental visits and the Medicare Advantage Enrollment and Benefit Documentation for information on individual Medicare Advantage plans. In order to provide a more accurate picture of dental benefits beyond what is available in these proposed documents, we examine the dental coverage provided by 10 geographic Medicare Advantage plans supported by different insurers that provide dental benefits (see Methodology and Appendix for more information ). . .
Nearly 24 million people, or about half of all Medicare beneficiaries (47%), had no form of dental coverage in 2019 (Figure 1).
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Remaining Medicare beneficiaries have access to dental coverage through Medicare and private plans, including employer-sponsored plans and purchased individual plans.
In 2019, 29% of all Medicare beneficiaries had access to dental coverage through a Medicare Advantage plan (including 3% of Medicaid-eligible beneficiaries who had access to dental coverage through a Medicare Advantage plan). Another 16% had coverage through private programs. About 11% of Medicare beneficiaries had access to dental coverage through Medicaid (including those who also have coverage through Medicare Advantage plans). As Medicare Advantage enrollment increases, more Medicare beneficiaries have access to some dental coverage through a Medicare Advantage plan, so the share of all Medicare beneficiaries with some dental coverage will be higher in 2021.
A previous analysis of the 2016 Medicare Current Beneficiary Survey (MCBS) and other data sources showed that nearly two-thirds of the Medicare population (65%) had no dental coverage that year. However, due to a data collection and processing problem later identified by CMS, coverage estimates for dentists derived from the MCBS were lower than they should have been from the unknown size. CMS addressed this issue in 2017. Because of these and other improvements in our analysis, as explained in the methodology, we found that most people's Medicare dental insurance estimates cannot be changed using our 2016 estimate.
Lack of dental care can worsen chronic health conditions such as diabetes and cardiovascular disease, contribute to the diagnosis of serious medical conditions, and prevent complications that sometimes lead to costly emergency room visits.1 This is compounded by limited or no dental coverage and the cost of care. such as Medicare beneficiaries for the above procedures and other dental procedures.
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In 2018, half of Medicare beneficiaries had not seen a dentist (47%)—with higher rates reported among blacks or Hispanics (68% and 61%, respectively) (Figure 2).
When we looked at race and gender, we found a greater proportion of black and Hispanic women (64% and 59%, respectively) without a dental visit in the past year than white women (40%). The same pattern exists among men: a greater proportion of black men (74%) and Hispanic men (64%) than white men (44%) have not visited a dentist.
Low-income beneficiaries are much less likely to report a dental visit in the previous year than higher-income beneficiaries. Nearly three-quarters (73%) of Medicare beneficiaries with incomes below $10,000 per year did not see a dentist, compared to 25% of beneficiaries with incomes above $40,000.
Health status also correlates with dental care. Almost two-thirds (63%) of all beneficiaries with fair or poor self-rated health had a dental visit in the past year, compared to 41% of beneficiaries with excellent, very good or good health.
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These relatively low rates of dental use cannot be attributed to a decline in use due to the pandemic-coVID-19, as they are based on data from 2018, the most recent year available that was before the pandemic.
Most beneficiaries who received dental services in 2018 (88%) paid out of pocket. For all beneficiaries, the average out-of-pocket expense for dental care in 2018 was $454, even when covered.
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