No, Original Medicare (Medicare Part A and Part B) does not cover routine dental or vision care. There are certain circumstances under which Original Medicare may provide some coverage for dental or vision care in an emergency setting or as part of surgery preparation.
Medicare Advantage (Part C) plans are sold by private insurance companies and can offer benefits not available with Original Medicare.
Medicare Advantage plans that offer vision and/or dental benefits may not be available where you live. Be sure to compare your local plan options to find out what’s available where you live.
99 percent of 2024 Medicare Advantage plans cover vision benefits not offered by Original Medicare, and 97% of plans offer dental benefits, according to the Kaiser Family Foundation.1
Medicare Advantage (Medicare Part C) plans provide the same basic benefits that are covered by Original Medicare. Many Medicare Advantage plans also include coverage for other benefits that Original Medicare does not.
Many Medicare Advantage plans offer coverage for things such as:
Medicare Advantage plans in your area may offer one or more of the benefits listed above or none of them at all. Be sure to compare local plan options to find out exactly what benefits are offered, including any additional costs, coinsurance, usage restrictions and other important details.
In 2023, more than half (51%) of all Medicare beneficiaries were enrolled in a Medicare Advantage plan.2
You may be wondering if your specific issue is covered by Medicare, such as if Medicare covers dental implants. A Medicare Advantage plan with dental coverage can offer benefits that may include things like:
The specific coverage offered by your plan may not include all of the items listed above. Check with your plan carrier to learn more about the terms of your Medicare Advantage plan dental coverage.
No, original Medicare (Parts A and B), does not cover dental implants.
If you have an existing Medicare advantage plan, you should review your plan benefits information to view your specific coverage relating to dental implants.
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A Medicare Advantage plan with vision benefits may cover things like:
Check with your plan carrier to learn more about the terms of your Medicare Advantage plan vision coverage.
No. Medicare Supplement Insurance, also called Medigap, does not provide coverage for dental or vision care. Instead, these plans provide coverage for some of the out-of-pocket costs associated with Original Medicare such as deductibles, copayments and coinsurance.
Medicare Supplement and Medicare Advantage are not the same thing. Medigap plans may not be used in conjunction with a Medicare Advantage plan.
If you have Original Medicare coverage and receive vision or dental care under one of the specific instances that are covered by Medicare Part A or Part B (detailed below), your Medigap plan may be able to help pay for some of your Medicare coinsurance costs, depending on which plan you have and the type of treatment you receive.
You can learn more about Medicare Supplement Insurance by reading this helpful guide.
Original Medicare covers limited dental care. It does not cover most dental care or supplies, such as:
However, Medicare Part A (hospital insurance) will typically provide some coverage if you receive certain covered dental-related services in a hospital as an inpatient.
Original Medicare does not cover routine eye exams for contact lenses or glasses.
Medicare will typically cover cataract surgery to implant an intraocular lens if it’s performed with traditional surgical techniques or with lasers.
Following the procedure, Medicare Part B will typically provide some coverage for corrective lenses, limited to one pair of eyeglasses with standard frames or one set of contact lenses after each cataract surgery.
Medicare also covers eye prostheses for patients with an absence or shrinkage of an eye due to a birth defect, trauma or surgical removal. Coverage includes polishing and resurfacing twice per year.
Medicare Part B does not provide any coverage for routine eye exams, but Part B will typically cover some preventive or diagnostic eye exams for patients who are at risk of certain diseases or conditions.
An annual glaucoma test may be covered by Medicare Part B if you are at a high risk of glaucoma due to having diabetes, a family history of the disease, Hispanic and age 65 and older or African American and age 50 and older.
Glaucoma is a condition that causes damage to the optic nerve and can lead to permanent vision loss if left untreated.
Age-related Macular Degeneration (AMD) is a leading cause of vision loss and remains incurable. It is caused by the deterioration of the central portion of the retina.
Medicare Part B can provide coverage for certain diagnostic tests and macular degeneration treatments if you have AMD.
Those with diabetes carry the risk of developing diabetic retinopathy, which is a complication of diabetes that damages blood vessels in the retina and affects vision.
An annual exam for diabetic retinopathy can be covered by Medicare Part B if you have diabetes.
Medicare Part B typically provides coverage for tests designed to diagnose cataracts. A cataract is a clouding of the eye’s natural lens and is the leading cause of blindness around the world.
Medicare will generally cover a diagnostic eye exam to determine the type and extent of an injured eye. Coverage typically extends to eye infections and treating foreign objects in the eye.
Any such vision services that are received as a hospital inpatient may be covered under Medicare Part A.
Medicare Advantage plans are required to cover all of the vision and dental services that Original Medicare covers. Plans can also cover additional benefits not offered by Part A or Part B, but benefits vary from one plan to the next.
Call today to speak with a licensed insurance agent who can help you compare Medicare Advantage plans in your area.
We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.
Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.
Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.
Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.
Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.
A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.
If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.
1 Freed M, et al. (Nov. 15, 2023). Medicare Advantage 2024 Spotlight: First Look. Kaiser Family Foundation. https://www.kff.org/medicare/issue-brief/medicare-advantage-2024-spotlight-first-look.
2 Ochieng N, et al. (Aug 9, 2023). Medicare Advantage in 2023: Enrollment Update and Key Trends. Kaiser Family Foundation. https://www.kff.org/medicare/issue-brief/medicare-advantage-in-2023-enrollment-update-and-key-trends.
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