Wisdom teeth removal is a common dental procedure, often necessary due to pain, overcrowding, or infection. However, when it comes to Medicare coverage, beneficiaries may wonder whether their plan will help cover the cost of this procedure. In this article, we will explore whether Medicare covers wisdom teeth removal, the costs involved, and alternative options for those needing financial assistance.
Does Medicare Cover the Cost of Wisdom Teeth Removal?
Original Medicare (Part A and Part B) generally does not cover routine dental care, including wisdom teeth extraction. Medicare will only cover dental procedures if they are deemed medically necessary and performed as part of a covered service. For example, if wisdom teeth removal is required due to an underlying medical condition or if it is part of a hospital-related procedure, Medicare Part A may cover hospitalization costs but not the extraction itself.
When Does Medicare Cover Wisdom Teeth Removal?
Medicare may cover wisdom teeth removal in exceptional circumstances, such as:
- If the procedure is performed in a hospital due to severe complications like a serious infection or damage to the jaw.
- When the removal is required as part of treatment for another medical condition, such as reconstructive surgery following an accident.
- If the patient has a serious underlying health condition that makes the extraction a medically necessary procedure.
Can Wisdom Teeth Be Removed Under Medicare?
For most beneficiaries, Original Medicare does not cover wisdom teeth removal. However, some Medicare Advantage plans (Medicare Part C) may offer dental benefits, including coverage for extractions, depending on the specific plan. These plans are provided by private insurers and often include additional dental, vision, and hearing benefits not covered by Original Medicare.
If you have a Medicare Advantage plan, check with your provider to see if wisdom teeth removal is included in your dental benefits.
What to Do If You Can’t Afford to Remove Your Wisdom Teeth
If Medicare does not cover your wisdom teeth removal and you cannot afford the procedure, here are some alternative options:
1. Medicare Advantage Plans
- Some Medicare Advantage plans include dental benefits that cover tooth extractions.
- Contact your provider to check if wisdom teeth removal is covered.
2. Medicaid
- Medicaid may provide dental coverage, including wisdom teeth extractions, for eligible low-income individuals.
- Coverage varies by state, so check with your local Medicaid office.
3. Dental Discount Plans
- Some discount plans offer reduced rates for dental procedures, including wisdom teeth removal.
- These plans require a monthly or annual fee but can significantly lower your out-of-pocket costs.
4. Dental Schools
- Many dental schools provide low-cost or free dental services performed by supervised students.
- This can be a cost-effective way to get wisdom teeth removed.
5. Payment Plans & Financing Options
- Many dental offices offer financing plans that allow you to pay for the procedure in installments.
- Third-party financing companies, such as CareCredit, provide interest-free or low-interest financing for medical and dental procedures.
How Much Does It Cost to Have a Wisdom Tooth Removed?
The cost of wisdom teeth removal varies depending on factors such as the complexity of the extraction, location, and anesthesia type. Here is an estimate of common costs:
- Simple extraction (no surgery): $75 – $200 per tooth
- Surgical extraction (impacted tooth): $225 – $600 per tooth
- General anesthesia or IV sedation: $250 – $800
- Total cost for all four wisdom teeth: $300 – $3,000 (depending on complexity and sedation used)
Conclusion
Medicare generally does not cover wisdom teeth removal unless it is deemed medically necessary as part of a broader hospital-related treatment. However, Medicare Advantage plans, Medicaid, and alternative financial assistance programs may provide coverage options. If you are facing high out-of-pocket costs, consider exploring dental discount plans, dental schools, or financing options to reduce expenses. Always check with your Medicare provider or insurance company to understand your specific coverage.
Need Help Finding Medicare Plans with Dental Benefits?
If you’re looking for Medicare Advantage plans that cover dental procedures, contact a licensed Medicare advisor to explore your options today!
