A lot of folks that turn 65 and qualify for Medicare don’t like the fact that Medicare doesn’t cover Dental or Vision services. The main reason being that the insurance they had before turning 65 was a Group Employer Based Plan that had a Dental and/or Vision insurance option. Most opted into the Dental and Vision because it would provide coverage for their entire family for a very low monthly premium, and it was easy to pay – directly from their paycheck.
Most folks don’t really know what Dental and Vision is, what it covers, or what it doesn’t cover. Group dental and vision plans are based on the group participation, so the premiums are less. There really isn’t much coverage there when you look close. Let’s do that: Dental Insurance plans are all basically the same with minor differences in coverage from company to company.
All Dental plans have:
-Waiting periods for major services coverage such as root canals, bridge work, crowns, et cetera)
-Limited coverage on cleanings and x-rays that are typically limited to one or two visits a year with a co-payment.
-An annual maximum benefit typically between $1000-$1500. There’s no coverage after that amount.
-Limited networks of Dentists.
-Very little to no Orthodontic or Oral Surgery coverage.
Vision Plans aren’t much better. One question I get in EVERY workshop usually goes like this, “If Medicare doesn’t cover Vision – Is there any coverage for Cataracts, or eye diseases?” Well, the truth is that Vision Insurance is only “good” for one thing – Eyeglasses. Medical issues with your eyes, be it Cataracts, Glaucoma, Macular Degeneration, Astigmatism are ALL covered by Original Medicare and your supplement. Or, if you have a Medicare Advantage Plan, you are covered there too.
Vision insurance gives very limited coverage on eyeglasses and contacts. Also, it will give you limited coverage on the refraction portion of an eye exam. The medical portion of the eye exam that checks for diseases, damage, retina, et cetera; are all covered by Medicare.
I like to put it this way – The taxpayer will make sure your eyes are healthy, but they will not buy you the most expensive pair to Ray-Bans. Although, Medicare will pay for a pair of glasses for beneficiaries after cataract surgery. Usually a prescription will change after that so Medicare will foot the bill on eyeglasses then.
Private Dental and Vision plans are typically costly when compared to what you are paying for. Premiums are usually between $20 and $50 per month. Most folks only use it to have their teeth cleaned twice a year. In that event, you are paying much more in premiums that you would be if you just paid the dentist direct.
Vision services are on a changing trend as well. Here in Bowling Green, we have two different eye centers that provide very inexpensive plans. Like $59 for an eye exam and 2 pair of glasses. You cannot purchase insurance for that, and your copay’s are more than $59 usually with the coverage. These specialty shops are popping up all over our area and doing well.
In my opinion, you should really talk to one person before purchasing dental coverage – your dentist. If your dentist feels that you may be looking at long term major dental work, it may be right for you. If you go for a few cleanings a year and an x-ray, you may be better off just working something out with the dentist.
I do carry a number of the most popular plans for dental and vision. I do have several clients that carry that type of coverage. I just don’t think it’s something that EVERYONE needs or should have.
If you have questions or want an explanation of dental and vision coverage, look at the following:
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Sign up for a Turning 65 Medicare workshop here.