Medicare provides coverage for many medically necessary services, treatments, supplies, equipment, and more. But are vision and dental care part of this basic coverage?
This brings up a common question many people have… “does Medicare cover vision and dental?” In this article, we answer that question in clear, plain English. You will also find the average costs of vision and dental care and other helpful info.
Does Medicare Cover Vision And Dental?
The short answer is no. In most cases, Medicare will not cover the cost of vision and dental care. That said, there may be some situations where you can get these costs covered. Below we’ll take a closer look at this to see when you might be able to get Medicare to pay for your vision and dental care.
Original Medicare (Medicare Part A and Part B) does not provide coverage for routine vision and dental care and services. However, in some cases, Original Medicare may provide coverage for some vision and dental services. For Original Medicare to provide coverage for your vision and dental care, it must be medically necessary to treat a medical condition.
Original Medicare does not provide coverage for the following dental services when they are only for your dental health:
- Routine dental checkups
- Tooth extraction
However, if you need a dental service as part of treatment for your overall health, Medicare may provide coverage for it. Here are some situations where Original Medicare may provide coverage for your dental care:
- If you need an oral examination in a hospital prior to your kidney transplant
- If you need an oral examination in a rural clinic or Federally Qualified Health Center (FQHC) prior to your heart valve replacement
- Any dental services that are necessary for your radiation treatment for certain jaw-related diseases
- Ridge reconstruction when a facial tumor is removed
- Surgery to treat fractures of the jaw or face
- Necessary dental splints and wiring after jaw surgery
Original Medicare also does not provide coverage for routine vision services such as eye exams and the purchase of eyeglasses. However, if you have a chronic eye condition such as a cataract or glaucoma, Medicare may provide coverage for your treatment and services. Original Medicare will provide coverage for the following vision treatments and services:
- Surgery to help repair eye function caused by a chronic eye condition
- Eyeglasses or contact lenses after having your intraocular lens placed in your eye after cataract surgery
- Eye exam to diagnose a potential eye problem
Original Medicare provides coverage for vision care if you:
- Have diabetes. Original Medicare provides coverage for yearly eye exams to check for diabetes-related eye problems
- Are at high risk of having glaucoma. You are considered at high risk for glaucoma if you are:
- Part of a family with a history of glaucoma
- African American at the age of 50 or above
- Hispanic American at the age of 65 or above
Part C Coverage for Vision and Dental
However, some Medicare Advantage plans (Medicare Part C) provide coverage for vision and dental care. Medicare Advantage plans cover everything Original Medicare covers and usually offer some additional benefits as well. Coverage and out-of-pocket costs will vary depending on the specifics of your plan.
Many Medicare Part C plans provide coverage for routine vision and dental care.
How Much Do Vision and Dental Care Cost?
Vision and dental costs vary greatly depending on the type of care. An average pair of prescription eyeglasses costs around $350. A routine dental checkup and cleaning usually costs around $100.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series including: Does Medicare cover penile implants?