Oral and optical health are of paramount importance for seniors on Medicare. Proper care is vital to see the world around us and to enjoy our favorite guilty pleasure snacks.
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Dental and vision insurance for seniors on Medicare can help ensure you spend retirement doing the things you love most, rather than worrying about how to cover expensive dental and vision procedures.
Keeping your teeth and eyes healthy as you age can help prevent many serious health risks. Did you know that you can prevent over a dozen health risks by visiting the dentist just once a year?
Below, we help you understand dental and vision insurance for seniors, including enrollment and how coverage can help you maintain a healthy lifestyle through retirement.
Is Dental and Vision Insurance for Seniors Necessary?
Dental and vision insurance for seniors is crucial to promote proper dental and vision health through retirement. Once you reach age 65, you are ten times more likely to be diagnosed with cancer, including oral cancers.
Additionally, the risk for other oral diseases increases. These include:
- Gum disease (including gingivitis)
- Periodontal disease
- Tooth decay
- And more
Routine dental care can nip these health complications in the bud. Although you can receive dental care without coverage, it can become costly. For example, a basic cleaning can cost upwards of $300, depending on your location. Beyond the basic cleaning, dental procedures can cost tens of thousands of dollars without proper coverage.
In addition to dental, vision coverage is also essential in keeping seniors on Medicare healthy. Approximately one in three seniors on Medicare develop a vision-reducing eye disease. These can include:
- Macular degeneration
- Retinopathy
- Cataracts
- And more
Most of these diseases are treatable if found early. Vision coverage can help you access treatment as soon as an issue is detected. Luckily, dental and vision plans for seniors are available to cover both necessary benefits.
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Does Original Medicare Include Dental and Vision Coverage?
Dental and vision benefits are crucial as we age. Unfortunately, Original Medicare (Part A and Part B) does not offer coverage for dental, vision, or hearing services. That is why enrolling in a stand-alone dental, vision, and hearing policy is important to supplement your Medicare benefits.
When you enroll in Original Medicare, adding dental and vision to your rolodex of coverage makes sense. Obtaining dental, vision, and hearing coverage can prevent several major health concerns and help you keep up with routine health maintenance.
How Do Dental, Vision, and Hearing Plans for Seniors Work?
Dental and vision plans for seniors provide benefits Original Medicare does not cover. These plans combine dental, vision, and often hearing benefits into one easy-to-use policy. Dental and vision plans have a maximum benefit that the plan pays out each year.
When you enroll, you can choose your maximum benefit amount. Typical options range from a $1,000 maximum benefit to a $5,000 maximum benefit. So, you can decide which amount best fits your needs.
Plus, if you need more benefits in the future, you can change your coverage level at any time. However, you may encounter a waiting period before you can use significant service benefits.
An advantage to enrolling in a dental and vision insurance plan is the approval guarantee regardless of your health.
However, it is vital to ensure your doctors will accept your plan. Fortunately, many policies are PPO-style, so any dentist or optometrist may accept them. Yet, to receive the plan’s maximum benefit, you should see an in-network provider.
What Does Dental and Vision Insurance for Seniors Cover?
Dental and vision insurance for seniors often covers basic preventive care and significant services. Each plan and carrier offer different benefits. However, the most common benefits include:
- Routine dental cleaning and deep-root cleaning
- Cavity fills
- Root canals
- Bridges, crowns, and dentures
- Hearing exams
- Hearing aid coverage
- Routine eye exams
- Glasses
- Contact lenses
Not all plans cover hearing benefits. However, many available plans cover this additional perk.
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What is the Best Dental and Vision Insurance for Seniors?
The best dental and vision plans for seniors vary per policyholder. Everyone has different health needs and budgets, so it is not uncommon to choose a different policy than your neighbor or even your spouse.
Many insurance companies offer dental and vision plans. However, some of the best include Cigna, Aetna, and National General.
Cigna Dental and Vision Insurance for Seniors
Cigna dental and vision plans help Original Medicare seniors cover one of the biggest holes in their health care coverage. Cigna dental and vision policies offer coverage for seniors in 36 states and have accepting providers in all 50 states. So, if you want coverage to travel with you wherever you go, Cigna offers a plan to fit your needs. Additionally, Cigna dental and vision insurance for seniors also provides hearing benefits that include hearing aid coverage.
Cigna dental plans offer benefit amounts from $1,000 to $5,000 annually. This means there is a policy for everyone.
When you enroll in a Cigna dental and vision plan, you receive 100% coverage for your preventive services from day one. Then, for major services, you will receive 60% coverage in year one, 70% in year two, and 80% in year three. Major services include root canals, periodontal surgery, bridges and crowns, and complete or partial dentures.
Cigna provides one of the largest networks of trusted dentists, optometrists, and audiologists. When it comes to vision coverage, you will receive up to $200 for lenses from an accepted provider.
Additionally, when you use Cigna to cover hearing aids, you can receive up to $500 to help cover these costs.
Aetna Dental and Vision Insurance for Seniors
Aetna dental and vision plans are available in 36 states nationwide. Dental coverage comes with a $100 deductible and a $1,000 or $1,500 benefit. There is no waiting period for biannual cleanings, semi-annual exams, x-rays (except for full mouth x-rays), or fillings and extractions (excluding impacted wisdom teeth). You will have 60% coverage in year one, 70% in year two, and 80% in year three.
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There is a 12-month waiting period for major services with 60% coverage in year two. Coverage for major services includes root canals, periodontal surgery, bridges and crowns, and complete or partial dentures.
Aetna vision benefits come with 60% coverage for year one, 70% coverage for year two, and 80% for year three, with a $200 maximum for the first two years. This includes coverage for eye exams, eyeglasses, and contact lenses.
Besides vision and dental, Aetna hearing coverage comes with a $100 deductible and a maximum of $500 during any calendar year. Your benefits do not kick in until the second year. In year two, you will have 70% coverage. By year three, you will have 80% coverage.
National General Dental and Vision Insurance for Seniors
There are three different National General dental and vision policy options so that you can find the right ancillary coverage for your healthcare needs. Any policy will cover preventive, basic, and major services from day one. The annual maximum and select benefits will increase in year two.
The National General dental, vision, and hearing PPO plan has three benefit levels for dental benefits. All three levels pay for dental procedures, including routine exams and cleanings. The Level 2 and Level 3 plans cover major services at 25% in the first year and 50% in the second year.
The Level 2 and Level 3 plans also cover dentures at 25% in the first year and 50% in the second year. Implants are only covered on the Level 3 plan with 25% coverage in the first year and 50% coverage in the second year.
Level 1 has an annual maximum of $750 the first year and $1,500 the second year. Meanwhile, Level 2 has a maximum of $1,000 in the first year and $2,000 in the second year. Finally, Level 3 has an annual maximum of $1,500 in the first year and $3,000 in the second year.
Further, National General offers two plans for vision coverage, the L1 Plan and the L2 Plan.
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The L1 Plan has a $15 copay for annual exams, $130 maximum per 24-month period, and a $25 copay for lenses. The maximum benefit for progressive lenses is $55.
The L2 Plan has a $10 copay for annual exams with a $200 maximum per 12-month period. It also comes with a $25 copay on lenses. The maximum benefit for progressive lenses is $135.
Lastly, National General hearing coverage will pay up to $125 on diagnostic services, including hearing exams. It will also save you an average of 62% on hearing devices. Additional perks include a year of free follow-up care, two years of free batteries, and a three-year warranty for loss, repairs, or damage to hearing devices.
Do Dental and Vision Plans for Seniors Require Waiting Periods?
All carriers are different regarding waiting periods for dental and vision plans. Commonly, carriers do not have waiting periods for preventive and basic services. However, you may need to satisfy a waiting period before receiving coverage for dentures, glasses, hearing aids, and other major services.
Waiting periods typically last between six and twelve months, depending on the service and the carrier.
Dental, Vision, and Hearing FAQs
How To Enroll in Dental and Vision Insurance for Seniors on Medicare
The first step to enrolling in dental and vision insurance for seniors is understanding which policy works best for your needs and budget. Our agents help you review all the options available in your area and allow you to choose which plan and carrier work best for you.
Once you decide which coverage will be the best fit, our agents walk you through the application process to ensure you do not miss a step. Complete our online rate form to receive a free side-by-side comparison of all options in your area.
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Sources:
MedicareFAQ is dedicated to providing you with authentic and trustworthy Medicare information. We have strict sourcing guidelines and work diligently to serve our readers with accurate and up-to-date content.
- Dental Coverage, CMS. Accessed June 2022.
https://www.cms.gov/medicare/coverage/dental - Dental Services, Medicare. Accessed June 2022.
https://www.medicare.gov/coverage/dental-services - Eye Exams, Medicare. Accessed June 2022.
https://www.medicare.gov/coverage/eye-exams-routine
I am currently a Kaiser Senior advantage member. Is there a way to obtain Dental insurance and continue to use the dentist I’ve had for a number of years
Hi Elaine! Yes, if your current plan does not cover dental services, you can enroll in a stand-alone dental plan that does not affect your healthcare coverage through Medicare. You’ll want to review the plans network before enrolling to ensure your doctor will accept the coverage.
Hi there Jagger! I also like your site easy to understand the info. My question is, I just signed up for Medicare this year & Medicare part D just a week ago( I’m just learning what to do… so confusing) & have not chosen a supplemental plan (G) yet , can I Drop part D & enroll in an advantage plan with DVH now… my enrollment period ends in May I believe
Debbie, if you have a Medicare Part D plan that is active, you must wait until the Annual enrollment period to change to a Medicare Advantage Plan. If you do not have an active Part D plan yet, you can still switch to Medicare Advantage. However, many beneficiaries find that they receive more coverage and end up saving money by remaining on a Medicare Supplement and enrolling in additional Dental, vision, and hearing coverage. If you would like to speak with a Medicare Expert about this, please give us a call and we are more than willing to help you review which option works best for you.
If I decline DVH coverage now, can I sign up for it in a few years?
Joseph, absolutely! There is no timeframe in which you must enroll in DVH coverage, and it is always guaranteed issue, so no health questions are involved, however, some carriers do have age limitations.
Hi Jagger,
This is a very helpful website! Thank you for providing it.
My spouse has a dental (only) plan through AARP with Delta Dental. Most of the benefits sound very similar to the ones you list, but the monthly rate is $72 and it’s only dental. Should she switch to one of the ones listed here? Delta limits first year coverage to the basics, just like the ones above, but the basics are covered at 100% — cleanings, fillings, X-rays, and others. I’m not sure, but it seems to me that this 100% coverage makes it worth the extra $30-40 dollars per month. What’s your opinion?
It sounds like the upcoming Build Back Better Act will not include the DVH Medicare coverage that was talked about in the beginning. How do we get Congress to add it back? My wife needs three crowns desperately, having lost two of them and the third is broken. The DVH plans you discuss here all seem to cover at most 50% of crowns, and that’s not until the second year. That is still out of reach for us! How do we get complete dental coverage from day one like she used to have through my employer???
Hi Jen – thank you for your comment! We are glad you find our website so helpful. Unfortunately, it seems like only hearing benefits are on the table for Medicare expansion right now. The best course of action is to evaluate your spouse’s needs and compare D/V/H plans to her current standalone dental coverage. Then, she should choose the beste coverage based on health and budget needs.