Dental, Vision and Hearing Insurance with Medicare: Why You Need It
Dental, Vision and Hearing insurance plans are important for many reasons. While Original Medicare covers many things, it does not cover dental services, vision care, or hearing care, just as it does not have prescription drug coverage.
Serious health conditions like heart disease, stroke, or diabetes can be exacerbated by poor dental care, vision care, and hearing care. While the cost of these services can accumulate quickly, failure to address them can increase problems in the rest of your health.
With Original Medicare alone, it is difficult to afford the necessary treatments that can help prevent these serious conditions.
This blog post discusses why a Dental, Vision and Hearing plan is important an important part of your complete medical coverage and overall health care.
Do I need a plan for these three areas of coverage?
First, it’s important to understand if your Medigap (Medicare supplement plan) or your Medicare Advantage plan has these benefits.
Medicare supplement plans do not cover routine dental care, vision and hearing services.
Medicare Advantage plans (also known as Medicare Part C) do include those routine services. However, it is important to note that coverage under Medicare Advantage plans is often limited.
For the purposes of this post, we will not discuss the dental coverage, vision coverage or hearing coverage of Part C Medicare Advantage plans.
The details of Medicare Advantage plans will be covered in a future article.
If you have Original Medicare (Medicare Part A and Medicare Part B) along with a Medigap plan, you have very limited coverage on dental, vision and hearing services.
And as you are likely aware, the cost of these things can quickly add up.
What are Dental, Vision and Hearing plans for Medicare?
A DVH plan is a Medicare supplement insurance policy that covers all Medicare-covered dental care (including preventive services), routine vision exams and hearing tests.
The maximum benefit of these plans can vary. There are plans that offer a maximum benefit of $1,000, $1,500, $2,500, or even up to $5,000 depending on your state of residence.
A few of the carriers include Manhattan Life, Aetna, Cigna, National General, and Medico. Many times, these plans increase their coverage the longer you are enrolled.
What should I look for when shopping for a DVH plan?
There are many DVH policies to choose from. It is important that you compare the prices and features of each plan. If you have been to a doctor recently, you may consider the treatment that the doctor recommended and find a plan that provides that coverage.
For example, many older adults require more extensive, comprehensive dental care than just routine cleanings, fillings, and exams. Often, your dentist will recommend bridges, crowns, root canals, or dentures.
These procedures are considered “major” treatment, so you will want to make sure the dental plan you choose has major coverage. The average dental coverage is 50% of major treatment, up to a certain maximum amount.
The same applies to vision and hearing services. What treatment may you need in the future? Will you need to be fitted for hearing aids? Will you need eye exams to decide on your vision prescription for glasses or contact lenses? Will you need cataract surgery?
Make sure the plan you choose covers the hearing and vision benefits you need.
Of course, no matter the plan you choose, coverage will only apply if the insurance company deems the treatment as medically necessary.
That means that your doctor has to provide proof that the service was indeed medically necessary. (This is customary of all health services, not just those associated with Medicare.)
There is another thing to consider when comparing DVH plans in your area and zip code. You will need to know what providers you have access to. What providers are in your area and which plans do they accept? Are they in-network with the plan? Does the plan allow you to see providers out-of-network?
While these things can take time to consider, they are very important when considering a plan. It would be a waste of your money if you enrolled in a plan that had very little coverage in your area and for the treatment you need.
What is the best way to enroll in a plan?
While you can enroll in a plan by yourself, a licensed insurance agent can save you time and effort when both comparing plans and enrolling.
The agent will be able to guide you through the process, answer your questions and help with any enrollment issues.
Since Sunflower Senior Solutions is an independent brokerage, that means that our licensed insurance agents can compare plans with many carriers and can find you the cheapest plan that fits your needs.
The best part? We do all of this at no cost to you, even if you choose not to enroll in a plan. There is never any additional cost to work with one of our licensed insurance agents.
If you would like to make an appointment to discuss the benefits of these plans, please call us at 785-301-2716.
A Few FAQs
How much do DVH plans cost?
- Depending on your plan, the average cost is between $35 to $75 per month.
What are the common things that a DVH plan covers?
- Services include routine dental care, cleanings, x-rays, routine eye exams, contact lenses, glasses, and hearing aids are covered under these plans. But of course, there are usually limitations and can still be things that are not covered, depending on the plan.
How long are Dental, Vision and Hearing plans good for?
- The length of time varies based on the plan. Generally speaking, most insurance companies offer a year-long period with coverage from January to December. For some people who sign up in November or December, they may only get nine months’ worth of coverage instead.
What can I do if my Dental, Vision and Hearing insurance is set to expire?
- You are not automatically enrolled in a plan. But if you want to keep your coverage active, all you need to do is contact the insurance company. They will be able to tell you what options are available for renewal and how much they cost.
Are these plans guaranteed renewable?
- Yes, the health insurance company cannot cancel your plan for any reason other than non-payment of premiums.
When can I change my DVH plan? Do I have to keep it for an entire year?
- You can change your Medicare Dental, Vision and Hearing insurance plan as often as needed.
When can I enroll in a DVH plan?
- You can enroll in a plan anytime after you reach age 65. Some people do it once they become eligible for Medicare coverage, but there is no deadline to sign up for the plans and no penalty for signing up at a later date.
- If I sign up later, will I have to go through medical underwriting?
No, it is not typical for these plans to require medical underwriting.
Will I have a waiting period after I sign up?
- You may have a waiting period for some services, but there is no waiting period for routine care.
Do these plans cover macular degeneration?
- Original Medicare covers the tests to diagnose macular degeneration. Part B may cover the injections to treat it, and a prescription drug plan may cover the necessary medications.
- A medicare supplement plan is the most important thing to consider for macular degeneration. These may pick up the remaining 20% cost that Medicare Part B doesn’t cover.
Will Medicare cover anything that a DVH plan covers?
- Medicare does not offer a DVH plan, so you’ll need to obtain separate coverage for those services.
I have a Medicare Advantage plan. Do I already have DVH coverage with my Medicare Advantage plan?
- Yes, Medicare Advantage plans already contain DVH coverage and also some prescription drug coverage. As with the stand-alone plans, you will need to look at the benefits and limitations offered by these Medicare Advantage plans.
What is the best DVH plan I can get?
- There is no one best plan that fits every person. The best dental and vision plan depends on your unique health care needs. It also depends on your location, provider access, and budget.
An Example: Manhattan Life DVH Plans
Manhattan Life Dental Coverage
This plan has dental benefits that include a $100 deductible and either a $,1000 or $1,500 maximum benefit. There is no waiting period for routine cleanings, exams, x-rays, fillings, and extractions. During your first year, you will have 60% coverage. During year two, you will have 70% coverage, and then 80% coverage after three years.
There is a one-year waiting period for major services like crowns, bridges, root canals, periodontal surgery, and dentures.
Manhattan Life Vision Coverage
Manhattan Life vision care comes with 60% coverage after you have been enrolled in the plan for six months. During year two, you will have 70% coverage, and then 80% coverage during year three. This includes coverage for eye exams, glasses, and contact lenses. This plan has NO maximum outside of the policy’s yearly maximum.
Manhattan Life Hearing Coverage
Manhattan Life hearing coverage has a $100 deductible. like the vision coverage, it has NO maximum outside of the policy’s yearly maximum. Benefits do not begin until the second year in the plan. At that time, you will have 70% coverage. At year three, you will have 80% coverage.
For more information on Dental, Vision and Hearing plans, and to learn about Medicare, Medigap, and Medicare Advantage plans, check out the articles on our website.
We’ve also got a free Medicare guide, Medicare & You, that is a great resource for those just getting started on their Medicare journey.