Does Medicare Cover Night Guards?

For those who grind their teeth at night (it’s more common than you’d think), a night guard can be a lifesaver. But, many Medicare beneficiaries wonder – does Medicare cover night guards? Let’s break it down so you can rest easy (without grinding your teeth in your sleep)!

What is a Night Guard?

A night guard is a dental appliance worn over your teeth to prevent teeth grinding or clenching, medically known as bruxism. It’s typically worn during sleep to protect your pearly whites from damage.

Types of Night Guards

1. Soft Night Guards
   
   • Good for mild grinding.
   • Comfortable but not as durable.
2. Hard Night Guards
   
   • Better for heavy grinders.
   • Long-lasting but less comfy.
3. Dual-Laminated Night Guards
   
   • A mix of soft and hard layers.
   • The best of both worlds – durable yet cushioned.

Does Medicare Cover Night Guards?

Here’s the big question: will Medicare foot the bill for your nightly tooth protection? Unfortunately Medicare typically does NOT cover night guards because they are considered a dental device and not a medical necessity. Medicare Part A and Part B focus on covering medically necessary procedures. Dental care like night guards falls outside that scope.

As Henry Beltran owner of Medicare Advisors Insurance Group LLC often says “Medicare loves to cover the big stuff but when it comes to the small comforts like night guards well you’re usually on your own.”

But Wait – Are There Exceptions?

There are a few possible exceptions depending on the circumstances:

• Medicare Advantage Plans (Part C): Some Medicare Advantage plans offer additional dental coverage which might include night guards. Be sure to check with your plan provider to see if night guards are part of your dental benefits.
• Medical Necessity: In some cases if a night guard is deemed medically necessary due to an underlying medical condition it could be considered. This is rare but not impossible.

How Much Do Night Guards Cost Without Medicare Coverage?

If Medicare doesn’t cover your night guard what’s the damage to your wallet? Prices can vary based on whether you go with an over-the-counter option or a custom-fitted one from a dentist.

Cost Breakdown:

• Over-the-Counter Night Guards:
  
  • Costs around $15-$50.
  • They offer quick fixes but are generally less comfortable and less durable.
• Custom-Fitted Night Guards:
  
  • Costs can range between $300-$1,000.
  • These are professionally molded to your teeth providing better protection and comfort but they come with a hefty price tag.

As Henry Beltran puts it “A custom-fitted night guard may cost as much as a vacation but it saves your teeth for the long haul.”

Alternatives to Night Guards

If the cost of night guards is giving you pause here are a few alternatives that might be worth considering:

1. Behavioral Therapy:
   
   • Learning to manage stress can reduce teeth grinding over time.
2. Dental Appliances Covered by Medicare:
   
   • Devices like CPAP machines for sleep apnea (if that’s the cause of grinding) might be covered by Medicare.
3. Changing Sleep Position:
   
   • Believe it or not sleeping on your back might reduce bruxism.

Potential Drawbacks of Night Guards

Night guards sound like a great solution but they’re not without their quirks! Let’s dive into a few drawbacks with a pinch of humor.

Fit Issues

You could end up with a night guard that fits about as comfortably as a pair of shoes two sizes too small. Custom-fitted night guards solve this but at a higher cost. If you go for an over-the-counter option you might feel like you’re wearing a mouthful of plastic – because well you are!

Cleaning Hassles

Night guards need regular cleaning to avoid bacteria buildup. Skipping this might turn your night guard into a germ-fest. You wouldn’t leave your toothbrush unwashed for weeks right? Same rule applies here! If you’re lazy about it don’t be surprised when your dentist gives you the “I told you so” look at your next appointment.

Getting Used to It

Wearing a night guard at first might feel like sticking a giant marshmallow in your mouth before bed. It can take a while to get used to the sensation. But hey practice makes perfect! Henry Beltran humorously says “It’s like wearing braces but just at night and hopefully with fewer food restrictions!”

FAQs About Medicare and Night Guards

What type of Medicare plan might cover dental devices?

• Medicare Advantage (Part C) plans sometimes offer dental benefits that could cover devices like night guards.

Is there a difference between Medicare and Medicaid when it comes to covering night guards?

• Medicaid coverage for night guards depends on the state you live in. It’s more likely to provide dental benefits than traditional Medicare.

Can I use my HSA or FSA to pay for a night guard?

• Absolutely! If you have a Health Savings Account (HSA) or Flexible Spending Account (FSA) you can use those funds to cover your night guard.

Conclusion

So in short Medicare typically won’t cover your night guard unless you’ve got a Medicare Advantage plan with dental coverage. While night guards can be a bit pricey they might save your teeth from a world of damage down the road. As Henry Beltran always advises “It’s better to invest in protecting your smile now than to pay for it with dental bills later!”

If you have more questions or are curious about Medicare Advantage options feel free to reach out to us at Medicare Advisors Insurance Group LLC. We’re always here to help even if it’s not to cover your night guard!