Medicare Benefits Explained – Chapter 1

Medicare considers care such as exams, cleaning, eyeglasses, hearing aids, etc as maintenance care and not medically necessary. therefore such types of care are not covered by Original Medicare.
If you are carrying a Medigap plan, recall that all a Medigap plan does is to cover the deductibles, coinsurances, and Part B excess charges that Medicare reuires of the beneficiary. A Medigap plan does not cover anything the Medicare does not cover.
One way around for beneficiaries that like the Medigap coverage option is to acquire a stand alone dental and or vision plans. Dental plans are varied, but the key issues are cost, of course, and maximum allowable benefit. For years, it was tough to find a dental plan that covered more than $1000 or so per year in benefits. In recent years, the cost of dental care has ballooned, so plans with such a low benefit are often not useful. I have found a number of plan options that offer scaleable benefits as well as maximum benefits of up to $6000, as well as the ability use network dentist or to see any dentist in the country.
Most stand alone vision plans are structured very similarly — a low or no cost copay for an annual exam, and an allowance for eyewear of $125-$200 annually. Some plans are less generous. Names you may have heard of for such plans are VSP and EyeMed. The size of networks of doctors on these plans tend to be huge, so selection is often not an issue.

A Medicare Advantage plan can cover non-Medicare benefits, and many MA plans do cover some level of dental, vision, and hearing. For instance, some plans today embed a preventive dental benefits within the plan’s structure, as well as vision exams and an allowance for hardware. Some plans even offer copays for hearing exams and hearing aids.

Most of us have gotten into the habit of getting our eyes and teeth regularly scheduled. But hearing exams are another matter. Since hearing can decline almost imperceptibly as we age, and we generally never developed a habit for periodic exams, we often let our hearing loss go undetected. Here are a few questions to ask yourself to see if you should get an exam::

It might be a really good idea to take advantage of plan benefits that allow you to get annual hearing exams, particularly if they are at low or no cost as many are.

Give me a call this week and let’s check out your options together.