Medicare covers many medical services but Medicare does not cover such basic services as dental coverage, eye exams, eyeglasses and hearing aides are not included
By Joanna R. Leefer (as seen in Courier Life newspaper group)
My friend Meredith was excited when she turned 65 and became Medicare eligible. The medical plan she had subscribed to while working was expensive and limited. Sometimes she had to travel quite a distance to find a doctor that accepted her health plan. She was thrilled that she would finally have a wider selection of medical doctors and be covered for regular check-ups and many important diagnostic tests. Now with a monthly premium of only $105 and a yearly deductible of $147, she was able to visit participating Medicare doctors in all parts of the country. There were benefits to being older!
Medicare Part B does not cover Dental Exams
Then Meredith went for her annual dental check up and got her first shock. The receptionist informed her that Medicare does not cover basic dental care. She was no longer covered for basic dental checkups cleanings, fillings, tooth extractions or dentures, dental plates or other dental devices. These services must be paid out of pocket. The only dental services Medicare covers are serious dental procedures usually performed in a hospital like jaw reconstruction following accidental injury or extractions before cancer radiation therapy.
Almost 50 million Americans currently receive Medicare outpatient medical care, usually referred to as Medicare Part B. By the year 2020, the number of participants is expected to increase to 84 million due, in part to the increasing growth of the 65+ population, the primary users of Medicare.
Medicare Part B does cover routine Medical Examines !
Medicare B can come as a blessing for many. It covers annual check-ups, diagnostic tests that prevent illness or detect it at an early stage, such as pap tests, flu shots, and colorectal cancer screenings. It also covers lab test, X-rays, physical therapy and other rehabilitation services. However many people are unaware of the services that are not covered.
Medicare Part B does not cover eye exams, eyeglasses and hearing aids!
Meredith soon became aware of two other services that are not covered. She discovered that Medicare does not include basic eye care. She was no longer able to get routine eye exams, eyeglasses or contact lenses. Medicare will cover some surgery for the eyes such as cataract surgery and will pay for the lenses or glasses after surgery. In addition it covers an annual eye exam if you have diabetes (which increases risk of retinopathy, e.g. damage to the retina and blindness).
Then she discovered that Medicare does not cover routine hearing exams or any kind of hearing aid. The only time Medicare will cover hearing problems is if they are due to a head injury or the removal of a brain tumor. Medicare may also cover implants to treat severe hearing loss.
Medicare is divided into four parts: Medicare Part A, B, C, and D. Medicare Part A pays for most inpatient hospital care, some home health care services and hospice care. Part B covers most out-of-the hospital office services such as doctor visits, outpatient hospital care, ambulance services and some medical equipment and supplies. Part A & B together are often referred to as Original Medicare.
Optional programs cover what Medicare Part B does not.
Medicare Part D is an optional program that helps pay for prescription drugs. If a person signs up for a Part D plan, he must pick from one of several private drug plans that have been approved by Medicare. Many of these plans offer slightly different types of drug coverage at different costs and with slightly different benefits.
Medicare Part C, often referred to as Medicare Advantage, are plans offered by private companies that the government has approved to provide medical care services. HMO’s and PPO’s are part of Medicare Part C. These Advantage Plans can be selected as a substitute for Original Medicare (Part A and Part B). Part C must provide at least the same benefits as Original Medicare but can vary the degree of coverage and use a different cost structure. Several Medicare Advantage plans do cover some basic eye, ear, and dental practices and procedures but beware; these procedures are often very basic and might include high deductibles or copayments.
A second option to cover eye, ear, and teeth is to sign up for a Medigap program. Medigap programs supplement Original Medicare and often include services that are not provided through it. Medigap plans include a monthly fee, copayments and deductibles. AARP, Aetna, and Humana are a few of the companies that provide supplemental coverage.
A third option that may be available to some seniors are services through community agency or teaching institutions. Many seniors have found that teaching hospitals in their communities offer free or inexpensive dental, eye or ear services.
The biggest step to getting all your needed medical services after you turn 65 is to be knowledgeable and be prepared. Most people are still happy with Medicare as their primary health insurance, but being aware of what is and is not available in your plan can make a big difference in your happiness.