Dental & Vision Plans
Here at PDX Insurance & Associates, we prioritize finding you the best ancillary coverage.
Dental & Vision Plans for Medicare Beneficiaries
Medicare plans provide extensive coverage for many health-related needs. However, dental and vision coverage can be more limited. For example, Original Medicare does not offer routine dental coverage. This gap means that services such as routine cleanings, exams, x-rays, fillings, extractions, and dentures are not covered. Medicare Part A (hospital) may cover specific dental services if they are required for a covered procedure.
Similarly, routine vision care, including eye exams and the cost of glasses or contact lenses, is not covered under Original Medicare. Medicare Part B (medical) does cover certain vision services related to specific medical conditions, like:
Eye exams for diabetic retinopathy
Eye exams for glaucoma
Cataract surgery
Options for Additional Coverage
Selecting the right Part D plan involves several key considerations:
Costs: Assess the costs associated with each plan, including premiums, deductibles, coinsurance, and coverage gap.
Coverage of Medications: Review each plan's list of covered drugs, known as the formulary. Formularies are organized into tiers that dictate how much you pay. Ensure that your current medications are covered and check for any restrictions, such as prior authorization.
Pharmacy Network: Verify that your preferred pharmacies are included in the plan’s network. Additionally, some plans offer better savings if you use certain pharmacies.
What to Consider When Choosing
Similar to other coverage, weighing your options and comparing plans to find your best fit is crucial. Here are some things to consider:
Evaluate Your Needs: Assess your dental and vision care needs based on your current health conditions, existing dental and vision problems, and future care requirements.
Review Benefits: Whether you’re considering a Medicare Advantage plan with dental and vision benefits or standalone insurance plans, compare them thoroughly. Ensure that the plan you choose includes the services you need and that you have access to your preferred providers.
Review Costs: Understand the costs associated with each option, including premiums, copayments, and out-of-pocket expenses. Consider how these costs fit into your overall healthcare budget.
When to Enroll
You can review, change, add, or remove dental and vision coverage during any Annual Enrollment Period (AEP), which runs annually from October 15th to December 7th.
