ArcaMax

Dear Toni,

I am currently on COBRA with dental benefits. I will need dental insurance when I lose my COBRA benefits after enrolling in Medicare at 65 in March. The only dental plans I am finding are in Medicare Advantage HMO/PPO plans. The office manager of my cardiologist’s office advised me not to go in the Medicare Advantage direction since Medicare Advantage plans are no longer accepted at his office beginning January 1, 2026. This office is only accepting Medicare and group health insurance.

Is there a specific dental plan that Medicare offers? Please advise me what I should do, Toni.

—Faye from Memphis, Tenn.

Hello, Faye:

“What ISN’T Covered by Part A & Part B?” is explained on pages 55-56 of the 2026 Medicare & You handbook. There it states: “Medicare doesn’t cover everything. If you need certain services Part A or Part B doesn’t cover, you’ll have to pay for them yourself unless:

—You have other coverage (including Medicaid) to cover the costs.

—You’re in a Medicare Advantage Plan or Medicare Cost Plan that covers these services. Medicare Advantage Plans and Medicare Cost Plans may cover some extra benefits, like fitness programs and vision, hearing, and dental services.”

Some of the items and services that Original Medicare does not cover are listed on page 55. They include: long-term care, eye examinations (for prescription eyeglasses and corrective contact lenses), cosmetic surgery, massage therapy, routine physical exams, hearing aids and exams for fitting them, concierge care and covered items or services you get from a doctor or other provider who has opted out of participating in Medicare (the last item is discussed further on page 60).

On page 56, the Medicare handbook explains that Original Medicare doesn't cover dental services like routine cleanings, fillings and tooth extractions or items like dentures. Original Medicare may pay for dental services that are specific to medical procedures such as a heart valve repair or replacement, an organ transplant or cancer-related treatments. (Chapter 2 of Toni’s “Medicare Survival Guide Advanced Edition” also discusses what is not covered by Medicare.)

Since Medicare does not cover dental care, I would recommend that you talk to your dentist and see which dental insurance plans he/she prefers.

When buying a dental plan, there are two types of dental plans to pick from. Verify which type of plan your dentist accepts before buying.

Faye, you can use either type of dental plan with Original Medicare with or without a Medicare supplement or with a Medicare Advantage plan. Again, make sure that the plan you choose is accepted by the dentist you like.

Another area that Medicare does not cover is vision benefits, which are discussed on page 41 of the 2026 Medicare and You handbook. One exception is that Medicare will cover one pair of eyeglasses with standard frames (or one set of contact lenses) from a supplier enrolled in Medicare after each cataract surgery that implants an intraocular lens. The Medicare Part B deductible will apply and after you meet the Part B deductible, you pay 20% of the Medicare-approved amount. Medicare Advantage plans have different costs and copays for vision benefits.

Toni’s new course, Confused About Medicare (a downloadable video series), and the “Medicare Survival Guide Advanced Edition” are available at www.tonisays.com.

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Toni King is an author and columnist on Medicare, Social Security and long-term care issues. She has spent nearly 30 years as a top sales leader in the field. If you have a Medicare question, email info@tonisays.com or call 832-519-8664. Sign up for the Toni Says newsletter at www.tonisays.com to keep up to date on Medicare changes.

©2025 Toni King. Distributed by Tribune Content Agency, LLC.

Copyright 2025 Toni King, Distributed by Counterpoint Media