Do you have to wait until Medicare’s Annual Enrollment Period to get a dental or vision plan?

Your Medicare plan might not cover your teeth or eyes. Here’s how to change that.

You may notice that Original Medicare normally doesn’t cover services such as dental or vision. If you don’t already have dental or vision coverage, you might be wondering if you have to wait until Medicare’s Annual Enrollment Period (AEP) to get it.

Here’s some good news: No. You don’t have to wait.

You can buy a stand-alone dental or vision plan, often through many different carriers, says Shelley Miller. She’s the owner and founder of S.R. Miller Consulting LLC, a Medicare consulting firm in St. Louis.

So, if you’re on the lookout for dental and vision coverage — or you’re considering an alternative to Original Medicare — here’s what you need to know.

Thinking about Medicare? Call a licensed insurance agent at (800) 827-9990 to talk about plans, or browse your options online today.

What does Original Medicare cover?

Original Medicare, which includes Medicare Part A (hospital insurance) and Medicare Part B (medical insurance), doesn’t normally cover things such as prescription medications. For prescription coverage, you’d have to buy a separate Medicare Part D plan.

Also, Original Medicare doesn’t cover routine dental care, according to Ari Parker, J.D. He’s the co-founder and head Medicare adviser for AskChapter.org. This includes:

• Annual exams
• Fillings
• Regular visits for cleanings
• Tooth extractions

In the same vein, Original Medicare doesn’t cover routine eye exams or the cost of eyeglasses or contact lenses. And it doesn’t cover routine hearing exams or hearing aid fittings.

You can, however, expect to get dental care covered if you receive treatment in a hospital setting, notes Parker. Let’s say you need surgery for a jaw fracture or dental services before radiation treatment for oral cancer. Those may be covered.

In these cases, Original Medicare will most likely cover the costs. It will also cover an annual eye exam if you’re at high risk for an eye condition such as glaucoma or diabetic retinopathy. Those at highest risk include people who:

• Are Hispanic and age 65 or older
• Are African American and age 50 or older
• Have diabetes
• Have a family history of glaucoma (a group of that can eye diseases cause permanent blindness)

Medicare will also cover tests and treatment if you are diagnosed with age-related macular degeneration, a disease which affects your central vision.

Medicare Advantage is an alternative to Original Medicare

You have another option besides Original Medicare. It’s called a Medicare Advantage plan (or Medicare Part C). This is Medicare-approved health insurance that you buy through a private insurance company. It gives you comparable coverage to Original Medicare. Plus, it can include additional coverage.

If you want dental and vision care up front, it could be a good alternative to Original Medicare.

When can I buy a stand-alone dental or vision plan?

You can buy stand-alone supplemental dental or vision plans at any time. Even if you’re enrolled in Original Medicare, you can opt for a dental or vision plan whenever you want.

Where can I buy a stand-alone dental or vision plan?

You can buy a stand-alone dental and/or vision plan from any offering insurance company. Many companies offer plans for customers of any age. There are also plans specifically geared toward people of Medicare age that offer extra age-relevant benefits, such as coverage for hearing aids and exams.

Otherwise, certain Medicare Supplement Insurance (aka Medigap) plans do offer dental discounts that can provide savings. Some insurance companies even allow you to add more dental coverage for an additional monthly bill (premium), according to Parker.

Are you interested in supplemental vision or dental insurance? Call a licensed insurance agent at (800) 827-9990 to talk about plans, or browse your options online today.

What questions should I ask before I choose a dental and/or vision plan?

Parker recommends asking yourself:

• Are the medical providers you want to see covered by the plan?
• What are the associated costs, including premiums, copayments and deductibles?
• Are there other out-of-pocket costs to factor in?
• What’s the maximum amount the plan will pay on an annual basis?
• Does the plan cover emergency services if you’re traveling away from home?

It’s also important to carefully look at your health history and family history, advises Miller. “If your parents lost their teeth early, you’ll want to look at a more comprehensive dental plan than someone whose family is genetically blessed with great teeth that require little dental work,” she notes.  

What if I want to wait to get covered until my AEP?

You can absolutely wait. You can always choose Original Medicare and standalone dental and/or vision coverage, or a Medicare Advantage plan that may include those benefits.

Need more information about Medicare plans? Call a licensed insurance agent at (800) 827-9990 to talk about plans, or browse your options online today.