UNITED STATES\u2014Dear Toni, I will be eligible for Medicare in July and am now receiving cancer treatment. I am currently on my ex-employer\u2019s COBRA and searching for dental care when I go on Medicare in July. The only dental\/vision plans I am finding are in Medicare Advantage plans, but my cancer facility has advised me to not go in that direction because many Medicare Advantage plans are no longer accepted at their facility.<\/p>\n
Is there a dental plan that Medicare offers? Please advise. Tammy from Alvin, TX.<\/p>\n
Hello Tammy: \u201cWhat\u2019s NOT Covered by Part A & Part B?\u201d is explained on page 55 of the 2024 Medicare & You handbook under What Isn\u2019t Covered Under Part A and B. It states:<\/p>\n
\u201cMedicare does not cover everything and if you need certain services that Medicare Part A and Part B doesn\u2019t cover, you will have to pay for them yourself unless:<\/p>\n
\u25a0 You have other coverage (including Medicaid) to cover the costs.
\n\u25a0 You are in a Medicare Advantage Plan or Medicare Cost Plan that covers these services.<\/p>\n
Medicare Advantage Plans and Medicare Cost Plans may cover some extra benefits, like fitness programs and vision, hearing, and dental services.<\/p>\n
Some of the items and services that Original Medicare does not cover include:
\n\u2022 Eye examinations (for prescription eyeglasses)
\n\u2022 Long Term Care
\n\u2022 Cosmetic surgery
\n\u2022 Massage therapy
\n\u2022 Routine physical exams
\n\u2022 Hearing aids and exams for fitting them
\n\u2022 Concierge care (also called concierge medicine, retainer-based medicine, boutique medicine, platinum practice, or direct care)
\n\u2022 Covered items or services you get from an opt out doctor or doctor not accepting Medicare. (go to page 60)
\n\u2022 Most dental care: Original Medicare doesn’t cover dental services like routine cleanings, fillings, tooth extractions, or items like dentures. However, in some cases, Original Medicare may pay for some dental services related to specific medical procedures like:
\n\u2022 A heart valve repair or replacement
\n\u2022 An organ transplants
\n\u2022 Cancer-related treatments<\/p>\n
Since Medicare does not cover dental, I would recommend that you talk to your dentist and see which dental insurance plans he\/she prefers. (Chapter 2 of Toni\u2019s Medicare Survival Guide Advanced edition also discusses what is not covered by Medicare.)<\/p>\n
When purchasing a dental plan, there are two types of dental plans to pick from:(verify which type of plan your dentist accepts before purchasing)<\/p>\n
1) Traditional (or indemnity) dental insurance plans are generally higher in premium, and the preventive services are usually covered at 100%, basic restorative is generally covered up to 80% and major procedures at 50%. Recently, new dental plans have been released which help with the costs of dental claims such as fillings, crowns, and root canals. A major surprise is that these plans begin immediately with no wait.<\/p>\n
2) Discount dental insurance plans are generally less expensive than traditional dental plans. These plans provide a discount for services, but your dentist must be part of the plan\u2019s network and agree to give the dental discount.<\/p>\n
You can use either type of dental plan with Original Medicare with or without a Medicare supplement or with a Medicare Advantage plan. Again, make sure that the plan you choose is accepted by the dentist you like.<\/p>\n
You did not ask about vision benefits, Tammy, but readers may want to know that the Medicare handbook discusses eyeglasses (after cataract surgery). This is a limited benefit because Medicare will cover one pair of eyeglasses with standard frames (or one set of contact lenses) after cataract surgery that implants an intraocular lens. The Medicare Part B deductible will apply and after you meet the Part B deductible, you pay 20% of the Medicare-approved amount. Medicare Advantage plans have different costs and copays for vision benefits.<\/p>\n
Toni\u2019s new course, Confused about Medicare, a downloadable video series, and the \u201cMedicare Survival Guide Advanced\u201d edition are available at www.tonisays.com.<\/p>\n","protected":false},"excerpt":{"rendered":"
UNITED STATES\u2014Dear Toni, I will be eligible for Medicare in July and am now receiving cancer treatment. I am currently on my ex-employer\u2019s COBRA and searching for dental care when I go on Medicare in July. The only dental\/vision plans I am finding are in Medicare Advantage plans, but my cancer facility has advised me […]<\/p>\n","protected":false},"author":482,"featured_media":165184,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[20324],"tags":[10393,22611,38408,10998],"class_list":["post-180141","post","type-post","status-publish","format-standard","has-post-thumbnail","category-toni-says-medicare","tag-dental","tag-enrollment","tag-losing-benefits","tag-medicare"],"yoast_head":"\n