Vision and Dental coverage with Medicare

Posted:June 15, 2015

We often receive calls from members asking about vision and dental benefit coverage. Unfortunately, Medicare does not cover routine eye exams for eyeglasses or contact lenses and most dental care procedures or supplies such as cleanings, fillings, tooth extractions, dentures, dental plates, or other dental devices. Group or individual vision and dental plans, separate from Medicare, could help with these exams and services. However, there are certain situations where Medicare Part B will cover preventative and diagnostic eye exams and Medicare Part A will pay for certain dental services that you receive when in a hospital.

Members with Diabetes

• Part B will cover a yearly eye exam for diabetic retinopathy.

Members with a high risk for Glaucoma

• Part B will cover a glaucoma test once every 12 months.

Members with age-related Macular Degeneration

• Part B will cover certain diagnostic tests and treatments of diseases and conditions of the eye, including treatment with certain injected drugs.

These screenings must be done by a doctor who is legally allowed to perform this test in your state.

Medicare Advantage Plans can offer additional services that include dental and vision, but if you are enrolled in original Medicare it may be beneficial for you to enroll in an additional vision and dental plan to cover these extra services.

If your doctor requires that you receive treatments and screenings that Medicare does not cover, you are responsible for these charges. Please visit www.medicare.gov for more information on what is covered under Medicare.

EYEGLASSES