November is National Diabetes Month, and most of the attention goes to blood sugar, diet, and medication. But diabetes can also affect two parts of the body that are easy to overlook: your eyes and your gums. Regular eye and dental care are part of managing diabetes well — and your dental and vision coverage, along with your health plan, can help you keep up with both.
Why Your Eyes Need an Annual Check
Over time, high blood sugar can damage the small blood vessels in the back of the eye. Diabetic eye disease often has no early symptoms, so it can progress before you notice a change in your vision.
That is why diabetes organizations recommend that adults with diabetes have a dilated eye exam at least once a year, or as often as their eye doctor advises. During a dilated exam, the eye doctor widens the pupils to look at the retina directly, which is how early changes are found.
Why Your Gums Matter Too
People with diabetes are more likely to develop gum disease, also called periodontal disease. The link appears to work in both directions: diabetes can make gum infections harder to fight, and serious gum disease may make blood sugar harder to control.
Gum disease is often painless in its early stages. Regular dental visits — commonly every six months, or as your dentist recommends — give your dentist a chance to catch problems early. Be sure your dentist knows you have diabetes.
Which Plan Pays for What
This is where many people get confused, because more than one plan can be involved.
Eye exams. A vision plan typically covers a routine eye exam for checking your prescription, plus an allowance for glasses or contacts. An eye exam to monitor a medical condition such as diabetes is often billed to your medical plan instead, under your health plan’s specialist or office visit benefits. Which plan applies depends on why the exam is done and how your eye doctor bills it, so ask the office before your visit.
Dental care. Dental plans typically cover preventive cleanings and exams at a high level, often twice a year. Treatment for gum disease, such as a deep cleaning, usually falls under basic or major services, with a deductible and coinsurance. Some dental plans offer additional cleanings for members with diabetes; check your plan documents or call the carrier to find out whether yours does.
Getting the Most From Your Coverage
- Schedule your dilated eye exam and dental visits now, before your plan year resets
- Ask your eye doctor’s office which plan they will bill — vision or medical
- Ask your dental plan whether it offers extra cleanings for members with diabetes
- If you don’t have dental or vision coverage, consider whether adding it makes sense for next year
A Familiar Scenario
David, who has type 2 diabetes, went in for what he thought was his yearly vision plan exam. Because the visit included a dilated exam to check for diabetic eye disease, the office billed his medical plan. A quick question at check-in would have helped him know what to expect — and confirmed he still had his vision allowance for new glasses.
We’re Here To Help!
If you are not sure what your dental and vision plans cover, or you are considering adding coverage for next year, we can walk through your options with you. Individual and group dental and vision plans are both available. Call us at 818-253-1736 or use the contact form on our website.
This article is general information and is not medical advice. Talk with your doctor, eye doctor, or dentist about the care that is right for you. Coverage, frequency limits, and billing vary by plan; check your plan documents or contact your carrier for details.