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Does Medicare Cover Dental?

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Medicare can be a complicated system in general. Knowing your options when it comes to dental coverage under Medicare might be challenging.

It’s critical to understand whether Medicare covers dental care if you’re concerned about your oral health. Examine the various Medicare plans to see how dental expenses may or may not be covered.

Does Medicare cover dental care services?

No and yes. The majority of dental services are not covered by Original Medicare, and Medicare dental policies are not available for purchase. Original Medicare doesn’t cover dental services like fillings, extractions, dentures, and more if you’re looking for coverage for routine procedures like teeth cleaning and X-rays as well as more specialized care. There are, however, methods for obtaining dental coverage under some Medicare plan varieties.

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What are some types of Medicare dental coverage?

There are numerous variations of Medicare, and each one offers a different level of dental coverage if any.

Dental coverage with Medicare Advantage Plans

Part A and Part B of Original Medicare are combined into one comprehensive plan by Medicare Advantage Plans, also known as Part C. Private insurance providers that have been authorized by the government’s Medicare program provide these policies. Additionally, these plans might provide extra benefits like dental coverage that are not provided by Original Medicare. Additionally, vision and Part D prescription drug coverage may be included in some plans.

In terms of price and coverage, Medicare Advantage Plans function similarly to conventional health plans. There are HMOs, PPOs, POS plans, and more, for instance. Deductibles, copays, and coinsurance are a few examples.

However, not every Medicare Advantage Plan includes dental coverage.

Therefore, be sure to read the specifics of what the plan covers before enrolling. Make sure the Medicare Advantage Plan you select covers the dental services you require if you want Medicare dental coverage.

Dental coverage with original Medicare, Part A, and Part B

Hospital insurance Part A and medical insurance Part B make up Original Medicare. The only situation in which Original Medicare might pay for any dental services is if you underwent hospitalization due to a traumatic injury that also affected your jaw, teeth, or mouth. Then, some of that dental care might be covered by Original Medicare.

It’s important to know what your Medicare plan would cover in detail before an accident occurs.

Dental coverage with Medicare Supplement Insurance Policies

Dental insurance is not included in Medicare Supplement Insurance policies. However, these programs do assist with out-of-pocket expenses that Original Medicare does not cover. Need dental coverage?

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Comparing dental coverage under Medicare

Here are the many forms of Medicare, what they cover, and if dental treatment is offered, in summary:

Benefits Details Medicare type What Kinds of Dental Coverage Are Offered? Primary Medicare (Part A and Part B)

  • Part A – Hospital Insurance
  • Part B – Medical

No
(Except: If hospitalized due to a serious accident that also affects the mouth, jaw, or face, it might be covered.)

Medicare Advantage (Part C)

  • Part A – Hospital Insurance
  • Part B– Medical Insurance


May also include:

  • Part D prescription drug coverage
  • Dental
  • Vision
  • Extra programs not covered by Original Medicare

Yes
(However, not all Medicare Advantage Plans include dental; be sure to check the plan’s specifics before signing up.)

Medicare Supplement Insurance

Costs not covered by Original Medicare (copays, deductibles, coinsurance)

No

What dental care services are covered by Medicare?

Only Medicare Advantage Plans (Part C) may provide dental coverage, and not all of them do, when it comes to Medicare and dental insurance. Typically, this coverage is basic and might include:

  • Teeth cleaning
  • Routine X-rays
  • Extractions
  • Fillings
  • And possibly more

Before enrolling in any Medicare Advantage Plan, be sure to read all of the fine print. Depending on the insurance provider and even your location, plans might change. There are frequent restrictions on the number of dental services that can be provided within a plan year, as well as maximum cost allowances and other restrictions.

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How do you get dental coverage if Medicare doesn’t include it?

There are other options you may think about if your Medicare plan is effective but does not cover dental care.

Buy a separate dental insurance plan

A private insurance provider may sell you a stand-alone dental plan. There are numerous dental insurance plan options available, most of which have low monthly premiums. You may be able to get coverage for preventive dental care through basic dental plans with lower monthly premiums. For a slight premium increase, other plans might offer a little more dental coverage. Deductibles, copays, and coinsurance are frequently included in standalone dental plans.

Find a walk-in dental clinic

There are reasonably priced walk-in dental clinics in many cities. You might be able to find affordable dental care, even if you have to pay out of pocket, depending on where you live and what kind of dental services you require.

Check with your state department of health

You might be able to find information on where to receive affordable dental care in your area on the oral health page of your state’s department of health.

Visit a local dental school

Whether there is a dental school or dental university program close by, you can get in touch with them to see if they give any community members any free or low-cost dental clinics.

Consider an HSA if you have a high-deductible plan

If you have a high-deductible health plan, you might think about opening a Health Savings Account (HSA) before the age of 65. Once you sign up for Medicare, you can no longer make contributions to the fund, but you are still welcome to use your savings to help cover eligible dental care and other covered costs.

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Why is dental coverage important?

Living a healthy life includes maintaining good oral health. Some Medicare Advantage Plans, but not all, may provide the fundamental dental coverage you need if you have Medicare. Dental care is excluded from original Medicare.

There are also many standalone dental plans to take into account. Prior to enrolling, do your research and read the fine print of any plan.

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