| Do Medigap Plans Cover Hearing and Vision?

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Medigap Plans | medicare supplement insurance

MEDIGAP PLANS HEARING AND VISION

If you’re wondering about whether Medigap plans will help cover hearing and vision costs, you’re in the right place. Read on to learn the details about Medicare Supplement insurance coverage and how it impacts your budget.

Medigap-plans-cover-a-wide-range-of-medical-services

Medigap plans help you cover healthcare costs that Original Medicare does not. Many people think in terms of annual wellness exams, surgery, and injury and illness coverage. But what about hearing and vision?

You might need glasses, contacts, hearing aids, or other products as you get older. Additionally, some screening services can be expensive.

Unfortunately, Medigap plans aren’t always easy to understand, and it’s important to plan for your every need when it comes to healthcare in retirement.

Let’s look at some of the facts about Medicare Supplement insurance and how it relates to your hearing and vision needs.

DO MEDIGAP PLANS COVER HEARING? 

Medicare-Supplement-insurance-does-not-directly-cover-hearing-or-vision-healthcare-costs

If you’re used to your group health coverage, you might have several different ways to cover healthcare costs, including hearing and vision. Once you switch to Original Medicare and sign up for Medicare Supplement insurance, however, your coverage will be different.

Medigap plans don’t cover hearing-related costs except in certain circumstances. For instance, if you’re struggling with balance issues, your general practitioner or family doctor might order a hearing test. Original Medicare and Medigap plans will usually cover those services because they could be related to a wider health problem.

However, Medigap plans won’t pay for services like hearing tests or hearing aid fittings. They also won’t cover hearing aids and similar medical equipment.

Medicare Part B will cover 80 percent of your costs related to medically necessary hearing and balance tests when they’re ordered by your doctor. If you have a Medigap plan that covers your Part B coinsurance, you won’t have to pay anything at all for these healthcare services.

Similarly, you’ll be responsible for your hospital copayment if you receive these tests as an outpatient at a hospital. Medicare Part A will cover the rest. Medigap plans might help you cover some of these costs.

DO MEDIGAP PLANS COVER VISION?

Medigap plans do not cover vision-related healthcare costs. Unfortunately, you’ll have to find other insurance if you want to save money on eye exams, glasses, contacts, and screenings. 

Original Medicare covers certain types of vision tests when they’re considered medically necessary. For instance, a yearly eye exam is covered by Medicare Part B for beneficiaries with diabetic retinopathy. Medigap plans that cover your Medicare Part B excess charges and deductible will allow you to receive this exam for free.

You can also receive coverage under Medicare Part B if you have age-related macular degeneration, often called AMD, or if you’re at risk for glaucoma. Again, Medigap plans can cover some of your out-of-pocket expenses by relieving you of hospital deductibles, coinsurance, and copayments.

DOES ORIGINAL MEDICARE COVER HEARING OR VISION HEALTHCARE COSTS?

Original Medicare does not cover hearing or vision costs except in the situations described above. The Commonwealth Fund, an organization that advocates for affordable healthcare, has outlined the many reasons why Original Medicare beneficiaries could benefit from vision- and hearing-related healthcare costs. 

According to The Commonwealth Fund, Original Medicare beneficiaries who paid out-of-pocket for vision healthcare services spent an average of $426 per year, while those who spent money on hearing-related services paid an average of $1,001 out-of-pocket.

WHAT ABOUT MEDICARE ADVANTAGE?

Certain Medicare Advantage plans include hearing and vision as well as dental. Medicare Advantage offers an alternative to Medigap plans, but there are many factors to consider.

For instance, most Medicare Advantage plans require you to see physicians and other healthcare providers within a given network.

Medigap plans don’t have those same limitations. However, if you don’t want to get separate hearing and vision coverage or pay for those services out-of-pocket, Medicare Advantage might offer an attractive option.

HOW CAN I GET VISION COVERAGE OUTSIDE MEDICARE?

If you have Original Medicare and Medicare Supplement insurance, you don’t have to go without hearing and vision coverage. For instance, you might consider a dental and vision insurance plan.

If you go this route, you’ll have to pay a separate premium for your coverage. In other words, you’ll have a premium for Original Medicare, one for Medicare Supplement insurance, and one for dental and vision.

The advantage to going this route is that you’ll have fewer out-of-pocket expenses when it comes to receiving healthcare services.

WHAT ABOUT HEARING COVERAGE?

You can also get a separate insurance plan for your hearing-related healthcare costs. The problem is that most insurance plans won’t cover hearing aids, which represent a major portion of any out-of-pocket costs you might incur.

Since Original Medicare covers medically necessary hearing and balance exams, you might want to avoid hearing insurance and stick with Medigap plans and dental and vision coverage. There are programs that offer financial aid to seniors who need hearing aids, which might help to defray your healthcare costs should you need hearing assistance.

CONCLUSION

It can be difficult to understand Medigap plans and exactly what they cover, especially when it comes to costs that Original Medicare deems medically unnecessary. Knowing your rights and options will protect you and help you choose Medigap plans that meet your specific needs. 

If you aren’t sure which Medigap plans might meet your needs, use Ensurem’s handy Medigap Quoter to get custom quotes based on where you live, your tobacco use, and any other necessary information. Comparing Medigap plans against one another or evaluating premiums for the same Medigap plan among different insurance companies will make your decision easier.

Medicare supplement insurance policies can help reduce your out-of-pocket healthcare costs and give you more control over your budget.

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