Hey Answer Girl -

Like many Baby Boomers these days, I'm assisting in the care of my elderly parents. Why doesn't Medicare cover any part of hearing aids, dentures or eye wear when it seems those are the things seniors need most?

- Lynn from Glenrock

The simple answer: Medicare doesn't cover hearing aids, dentures or eye wear because Congress doesn't require it.

"If Congress put it in the Medicare legislation, we would cover it. But they didn't, so we won't," said Mike Fierberg, a spokesperson for Centers for Medicare and Medicaid Services. "If Congress was willing to pay for it, it would be there. Congress doesn't currently cover it."

The Medicare program has suffered financially in recent decades thanks to a huge number of people needing the program's services. While the number of people on Medicare is rising exponentially, fewer and fewer people are working and paying into Medicare as a total part of the population. It's a decidedly unsustainable trend.

"It's always a tug-of-war trying to decide what to cover, since Medicare's financial outlook is not good," Fierberg said. "The question is, 'What's anybody going to do about it?' That's a decision for Congress to make. Everybody would like more benefits, and we'd love to give more benefits, but you've gotta deal with the real world here."

In 2009, the Medicare program will begin paying out more than it receives. And at that pace, Fierberg said, the program will be bankrupt by 2019.

"It is a very serious, substantial problem, and the longer it takes to come up with a solution, the more difficult that solution is going to be on everybody," he said.

However, he added, some of the more important extras (i.e. glasses) can be covered under a Medicare Advantage plan. These plans are provided by private companies and tend to have wider, more far reaching benefits than traditional Medicare plans offer.

The Advantage plans are sometimes no more expensive than regular Medicare, but sometimes can cost a significant amount, depending on the provider and the benefits within the plan.

The tradeoff for more benefits from an Advantage plan, Fierberg said, is that you must stay within the private company's network. This limits the number of doctors you can be treated by or drug stores where you can pick up medications, and in Wyoming, this can pose a problem. If, for example, you live in a small town somewhere in the middle of the state, you may not be able to get to a network hospital or store, thus making the Advantage plan impossible to follow.

Contact reporter Megan Lee at (307) 266-0589 or megan.lee@trib.com

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Answer Girl tackles your questions about Casper, the universe and everything else. Submit your questions by email to megan.lee@trib.com, or call Megan Lee at 266-0589. You can also write to Answer Girl, Box 80, 170 Star Lane, Casper, WY, 82602.