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Dental, Vision, and Hearing Insurance for Seniors with Medicare


Oral and optical health are of paramount importance for seniors on Medicare. Proper care is vital to see the world around us and 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.

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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 you tens of thousands of dollars without proper coverage.

Besides 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. This can include:

Most of these diseases are treatable if found early.

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Enrolling in vision coverage can help you access treatment as soon as an issue is known. Luckily, dental and vision plans for seniors are available to cover both necessary benefits.

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 will pay 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 benefit 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.

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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 plans 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 offers 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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Does Medigap or Medicare Advantage Cover Dental, Vision, and Hearing Benefits?

Medicare Supplement (Medigap) and Medicare Advantage plans are available through private insurance companies. However, the capabilities of each type of plan are not the same. Medicare Advantage plans can create their own benefits and set their own maximum out-of-pocket limits.

Medicare Advantage plans often provide you with these additional benefits. Usually, the plans include dental, vision, and hearing benefits for their policyholders.

On the other hand, Medigap plans do not have the freedom to create their own benefits. Because Medicare standardizes the plans to provide the same benefits across all carriers, these plans allow for lower overall costs than Medicare Advantage plans.

If you enroll in a Medigap plan, you must sign up for a stand-alone dental and vision insurance plan to receive such coverage.

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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 plan than your neighbor or even your spouse.

Many insurance companies offer dental and vision plans. However, some of the best include Aetna, Manhattan Life, and National General.

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 your first year, 70% in year two, and 80% in year three.

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.

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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.

Manhattan Life Dental and Vision Insurance for Seniors

Manhattan Life dental benefits also come 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 full-mouth x-rays), or fillings and extractions. You will have 60% coverage in year one, 70% in the second year, and 80% in year three.

There is a 12-month waiting period for major services. Coverage for major services includes root canals, periodontal surgery, bridges and crown, full or partial dentures, and full-mouth extractions (unlike Aetna).

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Manhattan Life vision benefits come with 60% coverage after six months, 70% in year two, and 80% in the third year. This includes coverage for eye exams, eyeglasses, and contact lenses. With Manhattan Life vision coverage, there is no maximum outside the policy’s yearly maximum (compared to Aetna’s $200 maximum).

Manhattan Life hearing coverage also comes with a $100 deductible but does not have a maximum outside the policy’s yearly maximum. Your benefits do not kick in until year two. In year two, you will have 70% coverage. By year three, it goes up to 80%.

National General Dental and Vision Insurance for Seniors

There are three different National General dental and vision plan options, so 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 will 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% coverage in the second year.

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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.

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.

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The L2 Plan has a $10 copay for annual exams with a $200 maximum per 24-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 when it comes to 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 when it comes to dentures, glasses, hearing aids, and other major services.

Waiting periods typically last between six and twelve months, depending on the service and the carrier.

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Dental, Vision, and Hearing FAQs

How much do dental, vision, and hearing plans cost?
The average cost for a dental, vision, and hearing plan is between $30 and $45 per month.
Do I have to go through underwriting to enroll in a dental, vision, and hearing plan?
Dental, vision, and hearing plans do not require medical underwriting. There are no health questions.
Does Medigap cover dental, vision, and hearing?
Medigap plans will only cover the same benefits that Original Medicare covers. Original Medicare does not cover dental, vision, or hearing benefits. Therefore, neither do Medigap plans.
Does Medicare Advantage cover dental, vision, and hearing?
Some Medicare Advantage plans come with dental, vision, and hearing coverage. However, benefits are usually minimal and involve networks. You need to check with your carrier directly to find out if you have ancillary benefits.
Does Original Medicare offer dental and vision?
Original Medicare does not offer significant 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.
What is the best dental and vision insurance for seniors?
There is no one-size-fits-all for ancillary coverage. Your best dental and vision plan option depends on your specific healthcare needs. It also depends on other factors such as your location and budget.

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.

  1. Dental Coverage, CMS. Accessed June 2022.
    https://www.cms.gov/Medicare/Coverage/MedicareDentalCoverage
  2. Dental Services, Medicare. Accessed June 2022.
    https://www.medicare.gov/coverage/dental-services
  3. Eye Exams, Medicare. Accessed June 2022.
    https://www.medicare.gov/coverage/eye-exams-routine

Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

6 thoughts on “Dental, Vision, and Hearing Insurance for Seniors with Medicare

  1. 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???

    1. 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.

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