Does Medigap Cover Dental and Vision Care?
While Medicare Supplement Insurance (Medigap) and Original Medicare (Medicare Part A and Part B) do not cover routine dental and vision care, Medigap plans can help beneficiaries pay for costs they may face if they get dental or vision care that are covered by Medicare. There are also other types of Medicare plans called Medicare Advantage plans that may provide routine dental and vision coverage.
Here’s how each type of Medicare provides dental and vision benefits.
Original Medicare Covers Some Emergency Dental Care and Cataract Surgery
Medicare Dental Coverage
Original Medicare does not cover most dental care such as cleanings, fillings, tooth extractions, dentures, dental plates or other dental devices. However, Medicare Part A can pay for certain dental services performed in a hospital.
According to the Medicare.gov dental coverage rules, “Medicare Part A can pay for inpatient hospital care if you need to have emergency or complicated dental procedures, even though the dental care isn’t covered.”
Some situations in which Medicare may cover dental services are listed below.
- You need surgery to correct fractures of the jaw
- You need dental splints as a result of jaw surgery
- You need tooth extractions in preparation of radiation treatment for neoplastic diseases
- You receive a dental exam in a hospital before a heart valve replacement or kidney transplant
- You have oral cancer or another disease that affects the jaw and require dental services for treatment
Keep in mind that every situation is unique and you should speak with your doctor to find out if a specific dental service will be covered by Medicare.
Medicare Vision Coverage
Original Medicare might offer some vision coverage, but it is also restricted. Original Medicare does not cover routine eye exams for glasses or contact lenses.
Medicare Part B provides some limited vision care, but it won't pay for routine eye exams or glasses and contact lenses.
Medicare Part B does, however, cover the following vision benefits:
- Annual eye exams for beneficiaries suffering with diabetes
- Annual glaucoma testing for those at high risk for the disease
- Age-related macular degeneration diagnostic testing and treatment (for some)
- Cataract surgery and associated corrective lenses
- Prosthetic eyes
Medicare Part B will pay for 80% of the Medicare-approved amount for the procedure, and you will be response for the remaining 20%. Keep in mind that the Medicare Part B deductibles and copayments still apply.
Medigap Plans Can Help Cover Medicare Deductibles, Copays and More
The 10 standardized Medigap plans that are sold in most states provide up to nine different benefits, but do not include dental and vision coverage. Medigap policies help cover some of the out-of-pocket costs tied to Original Medicare, such as deductibles, copayments and coinsurance.
According to Medicare.gov, “Medigap policies generally don’t cover long-term care, vision or dental care, hearing aids, eyeglasses, or private-duty nursing.”
However, if you suffer a dental emergency and must visit the hospital, a Medicare Supplement Insurance plan may provide coverage for Original Medicare deductibles, copayments or coinsurance that you may face.
Some Medicare Advantage Plans May Cover Dental and Vision Care
Many Medicare Advantage (Medicare Part C) plans include routine dental and vision coverage.
Medicare Advantage plans are required by law to provide all of the same basic benefits as Medicare Part A and Part B. Many plans may also offer extra benefits that Original Medicare doesn't cover, such as dental and vision care.
Medicare Advantage plans that cover dental and vision care may cover services such as:
- Routine eye exams
- An allowance for prescription glasses and contact lenses
- Routine dental exams
- Teeth cleanings
- An allowance for dentures
Find a Medigap Plan to Help Cover Your Medicare Costs
When you receive health care services that are covered by Medicare, you typically face costs such as a Medicare deductibles and coinsurance. These costs can add up quickly over time for covered services, which are in addition to your costs for any services you receive that aren't covered by Medicare.
Learn more about common procedures that medicare covers.
A Medigap plan can help make your health care costs more predictable, which can help you budget for your dental and vision care needs as a Medicare beneficiary.
Learn more about Medicare Supplement plans available near you and compare available plans to find the right fit for you.