As we get older, many of us will need additional support for dental, vision, and hearing. Original Medicare does not cover routine exams, but many Medicare Advantage plans offer this coverage in their more comprehensive packages.
Not covered by Medicare
Medicare has no coverage for most dental care, or for dentures. There is no coverage for vision exams for the purpose of prescribing glasses, nor is there coverage for contacts or eyeglasses. Hearing aids and exams to fit them are not covered by Medicare. Routine foot care is not covered. Medicare does not cover long-term care, which is sometimes called custodial care. Acupuncture is also not covered under Medicare.
Medicare Advantage coverage
Medicare Advantage plans are offered by private companies that have been approved by Medicare to handle your Part A and Part B coverage. The same coverage available under Original Medicare applies. Most plans offer prescription drug coverage as well, and many have dental, vision, and hearing coverage.
How Medicare Advantage works
Medicare Advantage plans come in a few standard types. These include HMOs, PPOs, PFFSs, and SNPs.
Health Management Organization (HMO) plans require the insured to have a primary care physician and require referrals to see specialists. Seeing physicians outside of the plan’s network will cost much more than providers in-network.
Preferred-Provider Organization (PPO) plans do not require that you have a primary care physician and do not require referrals to see specialists. While there is more flexibility in these plans, monthly premiums tend to be higher than HMOs.
Private-Fee-for-Service (PFFS) plans allow you to receive care from any physician that agrees to treat you and accepts the plan’s payment terms. These plans may have networks, in which case care is more affordable with in-network providers.
Special Needs Plans (SNP) are designed for specific ailments. Membership is restricted to people who have a certain chronic condition. Each plan has a network of specialists that treat that condition.
Enrolling in Medicare Advantage
To sign up for a Medicare Advantage plan, you can switch from Original Medicare to a Medicare Advantage plan during the Open Enrollment Period. This is between October 15 to December 7 every year. You can qualify to switch if you are already enrolled in Original Medicare, live within the plan’s service area, and do not have End-Stage Renal Disease.
If you already have a Medicare Advantage plan but are looking to find more dental, vision, and hearing coverage, you can switch to a different Medicare Advantage plan during the Medicare Advantage Open Enrollment Period. This falls between January 1 and March 31. You can make only one change during this period.
For more information about how to obtain dental, vision, and hearing coverage, reach out to Hitcho Insurance today!
