What many Medicare Beneficiaries need most in their ‘Golden Years’ is Dental, Vision and Hearing coverage. This can sometimes be the largest expense as we age. Ironically, Medicare does not cover Dental, Vision or Hearing at all; at least not yet as of 2023. This has been a topic of discussion in many recent legislative sessions. However, nothing has officially been done by the federal government to care for our Seniors’ teeth, eyes, and ears. But all is not lost! There are optional supplemental benefit plans offered by many insurance carriers. In addition, Medicare Beneficiaries can get D/V/H coverage through Part C or Advantage Plans. And finally, there are some providers that offer their own discount program for services. Let’s take a closer look at your options…….
Add On to Original Medicare
If you have Original Medicare with a Supplement or Medigap Plan, dental, vision and hearing are not included. However, you can add a separate plan or plans to address these needs. You don’t have to wait for a special enrollment period either. You can enroll any time of year in this type of add on. The downside is that it comes with more monthly premiums. The plans cover preventive services/exams and then offer discounts or cost sharing for comprehensive services (dental) and equipment (glasses, contacts, and hearing aids). Many of these plans are similar to what you may have had during your working years through an employer and have a maximum dollar limit. Many plans will advertise that they cover bridges and implants, but this is misleading. It will still only cover work done up to the maximum amount. And implants can be upwards of $15,000 to $20,000 out of pocket. No plan exists that will cover all of that.
Part C or Medicare Advantage
One of the ‘advantages’ of Medicare Advantage or Part C is that the plans include dental, vision and hearing coverage for no additional premium. The coverage amount varies by plan, however, is similar to the stand-alone plans described above. Preventive services are covered, and then there is an allowance for comprehensive services and equipment. Some plans have additional money on a flex spending card that can be used just like a pre-loaded credit card for dental, vision and hearing expenses. This is a great benefit, but the catch here is to be sure you are using in-network providers and vendors to really get full use out of the benefits. There are many dentists who do not take or want to bill any Advantage Plans. Be sure to check with your agent for in network dentists near you. Review your enrollment guide also for hearing aid and eyewear vendors. It should have them listed with contact information.
Self Pay and Provider Discounts
Some folks just opt to self pay. This is in the case of Beneficiaries who keep Original Medicare with a Medigap or Supplement plan. You can budget out your needs for dental cleanings and exams for self pay. Many dental and vision providers also have their own discount program for self pay individuals. In some cases, if you crunch the numbers, you could be better off using a provider discount program rather than paying a monthly premium for the same discounts. If you are really outgoing and confident, you may even be able to negotiate your own discount! Go get ‘em, Chief!
Smiling Ear to Ear
No insurance coverage is perfect, but the nice thing about optional supplemental benefit plans is that they can be changed anytime. So, if you try one and don’t like it or don’t see the cost savings, then you can drop it. There are also ways to get reimbursed for some of the costs on Advantage Plans if you do see an out of network provider. Your agent can help you with this. Having a local advocate is the best way to get the most out of what little is offered in this area!
CDI can help you through this entire maze. We can meet in person or virtually. Reach out if you would like more information. Email carrie@cdi-cares.com or check out www.cdi-cares.com for a contact page and other helpful blogs.