Toni,
Will be eligible for Medicare this year and trying to compare Medicare to my company benefits? I think that I understand the alphabet soup for Medicare, i.e. Parts A, B and D. Why doesn’t Medicare cover eye glasses/vision benefits or dental work? What insurance options do you recommend for these benefits Medicare does not cover?
~ Thank You, Tim from Dallas, TX
Hello…Tim:
On page 56 of the 2014 Medicare & You handbook under “What’s NOT Covered by Part A & Part B?” It states… “Medicare does not cover everything and if you need certain services that Medicare doesn’t cover, you will have to pay for them yourself unless you have other insurance to cover the costs.”
The Medicare & You handbook also states…
- You may have other insurance (including Medicaid) that could cover the costs.
- You may be in a Medicare health plan such as Medicare Advantage (Part C) that may cover these services.
- Remember, that if Medicare covers a service, then you generally have to pay deductibles, coinsurances and co pays.
Here are some items Medicare does not cover: Long term care, routine dental care, dentures, cosmetic surgery, acupuncture, hearing aids and exams for fitting hearing aids.
Since Medicare doesn’t cover dental, I would recommend that you talk to your dentist and see which dental insurance plan he/she prefers. Talk with the office manager because they know which dental plan has the most benefits or should I say gives “you the most bang for your bucks”. There are 2 different types of dental plans:
1) Traditional or indemnity dental insurance plans which are generally higher in premium and the preventive services are usually covered at 100%, basic restorative is generally covered up to 80% and major procedures at 50%. Many of the traditional/indemnity dental plans may have a wait for services such as fillings, root canals, bridges, crowns, etc.
2) Discount dental plans are generally less expensive than traditional dental plans. These are plans that give a discount for services, but your doctor must be part of the plan and agree to give the dental discount.
Make sure you understand which dental plan you pick because many can have a 6 month to a 2 year wait or longer for expensive dental procedures such as crowns, implants, etc.
Tim, you also asked about vision benefits including glasses. On page 42 of the Medicare handbook, it talks about eyeglasses which is a limited benefit because Medicare will cover one pair of eyeglasses with standard frames (or one set of contact lenses) after cataract surgery that implants an intraocular lens. The Medicare Part B deductible will apply and you will pay the 20% of the Medicare-approved amount.
Medicare defines glasses as an elective. Do not understand why glasses other than the frames after cataract surgery is considered elective (not covered), but it is. I would say “seeing” especially when driving is important, but Medicare will only pay for glasses when you have cataract surgery.
Hearing aids are also considered elective, just like glasses. “Medicare covers the exams if your doctor or other health care provider orders them to see if you need medical treatment. Again you pay the 20% of the Medicare-approved amount and the Part B deductible applies.” Medicare does not cover the hearing aids or exams for fitting the hearing aids and this can be expensive.
You can see that you cannot compare Medicare to your company benefits. And if you can keep these benefits when you retire, it might be a good idea. .
Confused About Medicare Workshops are coming back to the West U Senior Center join me on Monday, May 12th at 2:00 in the afternoon for the “Confused about Medicare” workshop at the West University Place Senior Center located at 6104 Auden, West University Place, (Houston) TX, 77005. Workshop is free, RSVP at 832/800-4674.
Toni King, author of the new Medicare Survival Guide®, which is a simple guide that puts Medicare in people terms, is on sales at www.tonisays.com. Schedule a “Confused about Medicare workshop by email at www.tonisays.com/ask-tonior call 832/519-TONI (8664)
