Offered by: Jennifer Bell – Bell Benefits, LLC
I thought I would share some experiences that I have run into lately that might help you avoid frustration so you can fully enjoy your summer.
Vision and Dental coverage that you might have included in your Medicare Advantage Plan can be a little interesting. It seems that some practices know what is covered in a routine exam and others have a misunderstanding. For example, some Medicare Advantage plans will cover a routine eye exam once per year at $0 copay. However, if your optometrist does some things that are not considered to be included in a “routine eye exam,” you will see a bill from their office.
Medicare Advantage plans may not cover refraction in a routine eye exam. Another thing that has been popping up in an eye exam that is not always covered is a 3D or 2D photo or Fundus photo. This takes a picture of the back of your eye. One bill I saw recently charged $35 for the refraction and $75 for the Fundus photo. So please get details of the exam from the provider’s office and then check with your insurance BEFORE you have your exam to find out what is and isn’t covered.
Dental benefits can also be tricky. Some plans will reimburse you after you have paid first. Other plans act like regular insurance giving you discounted rates. This version might leave you with a portion of the bill to pay rather than the entire bill. Some plans say they will pay the first $XXX and then you pay the rest. It’s very important to know how your plan works.
Remember, most health plans will subcontract another provider to handle the dental and vision benefits inside the Medicare Advantage Plan. That can be quite tricky too. Please let me know if I can help you
understand your benefits a little better. Just call or text 720-626-6524.