Dental, Vision, and Hearing Benefits with Medicare Advantage

Dental ,Vision, and Hearing coverage is included in most Medicare Advantage plans at no additional cost. Keep in mind that some Medicare Advantage plans do carry a monthly premium, however, most of those plan premiums are waived if the applicant qualifies for a Low Income Subsidy from the State of Florida and whether the plan charges a monthly premium or not there is usually no added cost for these ancillary benefits. Medicare beneficiaries that have Original Medicare and a Supplement will have to purchase dental, vision, and hearing coverage separate from their Medicare supplement policy. Remember that Original Medicare and a Supplement plan give you full Medical coverage, however, if these folks want these other coverages they will need to purchase these plans and pay for them separately.

Since Dental coverage is the most asked about after the medical of course, then let’s talk about Dental. Most Dental benefits that are covered in a Medicare Advantage plan offer $1000 of annual benefit and the copayments are usually fairly low. Pay close attention to the dental benefits when you are reviewing the Summary of Benefits for these plans because some Medicare Advantage plans only offer preventative dental which means your annual exam, your teeth cleaning, and X Rays are typically the only benefits when a plan is providing just preventative dental. If you have dental work that needs to be done then you’ll want to look at the Medicare Advantage plans that offer both Preventative as well as Comprehensive dental benefits. So, in addition to your Exam, Cleanings, and X Rays, you would also have coverage for the more costly procedures such as fillings, tooth extractions, periodontal scaling, crowns, bridges, and root canals. Some plans even offer limited coverage for dental implants. My observation has been that the companies that offer coverage for implants usually only cover 1 or 2 implants over a 5 yr period. Also what I have noticed is that the companies that do offer coverage for dental implants usually raise the copayments and the maximum out of pocket limits on the other coverages as compared to plans that don’t offer coverage for implants. I believe this is an effort by the Insurance Companies to offset their cost of offering implant coverage by raising the cost on the other services. I wouldn’t necessarily switch to a different Medicare Advantage plan just because they offer coverage for Dental Implants because you might find yourself paying up for the other plan benefits. Have your agent review all of the benefits to help you make the best choice. I would say the most important issue to consider during the Annual Election Period or when turning 65, when reviewing other Medicare Advantage plans, is to make certain that your Primary Care doctor and your Specialists accept the new plan. It is critical to make sure your doctors are in your plans network. When folks ask me what is the best Medicare Advantage plan I always have the same response. The best plan is one that most or all of your doctors accept. Dental coverage is really secondary to the Medical coverage but still important nevertheless.

Vision coverage can be helpful too. The cost is usually a Zero copayment to see a participating eye doctor and most Medicare Advantage plans give you an annual allowance that you can apply toward your frames or contacts. The allowance is usually about $200.00 and most of the major vision centers participate in these Medicare Advantage plans. These Vision plans typically cover the member for routine eye exams at a Zero copayment. If you are coming off a Group Plan make sure and ask your HR Dept if you can keep the dental and vision coverage. Many Companies will let you take the Dental and Vision with you at retirement and the cost for these plans are usually very reasonable and offer better coverage then individual plans. If your choice is to go with Original Medicare and a Supplement plan then you will need to purchase a separate dental plan and a separate vision plan.

Hearing coverage is also a benefit that is included in most Medicare Advantage plans. Most hearing benefits include a zero copayment to the doctor and also give you an annual allowance every 2 years. The allowance is usually about $600.00 per ear or $1200 for both ears for hearing aids and the fitting is usually at a zero cost to the member. Again, if your decision is to take Original Medicare you will need to purchase these ancillary plans outside of your Medicare Supplement plan.

Call Gary to discuss your best options.