As we age, it’s important to have comprehensive health coverage to take care of our medical needs. Medicare is a government-funded program that provides health insurance for those who are 65 and older or have certain disabilities. While Medicare covers many healthcare services, it doesn’t cover everything. This is why many people choose to buy a Medigap policy since they cover gaps that are left by Original Medicare. But, the question is do they cover dental, vision, and hearing? Well, the short answer is – no. However, you can choose to enroll in Medicare Part C, commonly known as Medicare Advantage plans, because most of them provide DHV coverage.
What are Medigap Plans?
Medigap plans, also known as Medicare Supplement plans, are private health insurance plans that help cover the “gaps” in coverage that traditional Medicare doesn’t cover. These plans are offered by private insurance companies, but they are regulated by the government to ensure they meet certain standards. Medigap plans are designed to work alongside Medicare, so you must have Medicare Parts A and B to be eligible for a Medigap plan.
What do Medigap Plans Cover?
Medigap plans are standardized and are identified by letters (A, B, C, D, F, G, K, L, M, and N). Each lettered plan offers a different set of benefits, and these benefits could include the following:
- Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
- Medicare Part B coinsurance or copayment
- Blood (first 3 pints)
- Part A hospice care coinsurance or copayment
- Skilled nursing facility care coinsurance
- Part A deductible (1600$)
- Part B deductible (only for Plans C and F): note that those two plans are no longer available for beneficiaries who weren’t eligible for Medicare before January 1st, 2020
- Part B excess charges (only plans G and F)
- Foreign travel emergency (up to plan limits)
What Medigap Plans Do Not Cover?
While Medigap plans help cover the gaps in Medicare, they do not cover everything. In particular, Medigap plans do not cover:
- Long-term care (such as nursing home care)
- Dental, vision, or hearing services
- Eyeglasses or contact lenses
- Private-duty nursing
- Prescription drugs (although you can purchase a separate Part D plan for prescription drug coverage)
So, to answer the question: No, Medigap plans do not cover dental, hearing, or vision services.
What are Medicare Advantage Plans?
Medicare Advantage plans, also known as Medicare Part C, are an alternative to Original Medicare (Parts A and B). Medicare Advantage plans are offered by private insurance companies that are approved by Medicare. These plans provide all the same coverage as Original Medicare, but they may also offer additional benefits, such as dental, hearing, and vision coverage.
What do Medicare Advantage Plans Cover?
Medicare Advantage plans are required to cover all the same services as Original Medicare, but they may also offer additional benefits, such as:
- Dental care (cleanings, X-rays, fillings, and extractions)
- Vision care (eye exams, glasses, and contact lenses)
- Hearing care (hearing exams and hearing aids)
- Prescription drug coverage (most Medicare Advantage plans include prescription drug coverage)
- Fitness programs and gym memberships
- Transportation to medical appointments
- Home health care services
It’s important to note that Medicare Advantage plans have networks, so you’ll need to see doctors and other healthcare providers that are in the plan’s network to receive full coverage. If you go out of network, you may have to pay higher costs.
Which Plan is Right for You?
Deciding between a Medigap plan and a Medicare Advantage plan depends on your individual needs and preferences. Medigap plans may be a good option if you want to keep your doctors and hospitals, and you’re willing to pay higher premiums for the additional coverage. On
On the other hand, if you’re looking for additional benefits like dental, hearing, and vision coverage, as well as prescription drug coverage, a Medicare Advantage plan may be the better option for you.
When choosing a Medicare Advantage plan, it’s important to research and compares the different plans available to you. Consider factors like the plan’s network, monthly premiums, annual deductibles, and out-of-pocket maximums. You can use Medicare’s Plan Finder tool to compare plans in your area.
In conclusion, Medigap plans do not cover dental, hearing, or vision services, but they do provide coverage for the gaps in Original Medicare. On the other hand, Medicare Advantage plans may offer additional benefits like dental, hearing, and vision coverage, as well as prescription drug coverage, but they have networks and may require you to see providers within the plan’s network. Ultimately, the right plan for you depends on your individual needs and preferences, so be sure to research and compare your options before making a decision.
Can I choose Medicare Advantage if I have a Medigap policy?
You cannot have both a Medicare Advantage plan and a Medigap policy at the same time. Medigap policies are designed to work alongside Original Medicare (Part A and Part B) to help cover out-of-pocket costs such as deductibles, coinsurance, and copayments. Medicare Advantage plans, on the other hand, provide an alternative way to receive Medicare benefits through a private insurance company, and may offer additional benefits not covered by Original Medicare.
If you enroll in a Medicare Advantage plan, you will not be able to use a Medigap policy to pay for cost-sharing expenses. Similarly, if you have a Medigap policy and decide to enroll in a Medicare Advantage plan, you will need to drop your Medigap policy, as Medigap policies are not compatible with Medicare Advantage plans.
It’s important to carefully review your healthcare needs and compare the benefits and costs of different Medicare options to determine which plan is best for you. You may want to speak with a licensed insurance agent or a Medicare representative to help you understand your choices and the implications of your decisions.
Can I have DHV if I want to keep my Medigap policy?
Yes, if you want to keep your Medigap policy, you can purchase separate insurance policies to cover dental, vision, and hearing (DVH) benefits. These policies are not part of Medicare, so you can purchase them from a private insurance company.
Some insurance companies offer a combined DVH insurance policy that covers all three benefits, while others may offer separate policies for each benefit. It’s important to carefully review the benefits and costs of different insurance policies to determine which one is best for your needs.