Does Medicare Cover Dental?

In general, the Medicare system can be challenging. It may be difficult to understand your options for dental coverage under Medicare.

If your oral health is a problem, it’s imperative to know whether Medicare covers dental care. Examine the different Medicare plans to determine whether or not dental costs are covered.

 

Does Medicare cover dental care services?

Yes and no. Original Medicare does not cover the bulk of dental services. If you’re searching for coverage for both standard operations like teeth cleaning and X-rays as well as more specialist care, Original Medicare doesn’t cover dental services like fillings, extractions, dentures, and more. However, there are ways to get dental coverage under some Medicare plan options.

What are some types of Medicare dental coverage?

Medicare comes in many distinct forms, and each one, if it includes dental coverage at all, gives a different level of it.

Dental coverage with Medicare Advantage Plans

Medicare Advantage Plans, commonly known as Part C, combine Part A and Part B of Original Medicare into a single comprehensive plan. These policies are offered by private insurance companies that the government’s Medicare program has authorized. These plans may also offer additional benefits not included in Original Medicare, such as dental coverage. Some plans may also offer vision and Part D prescription drug coverage.

Medicare Advantage Plans operate similarly to traditional health plans in terms of cost and coverage. For example, there are HMOs, PPOs, POS plans, and more. Examples include coinsurance, copays, and deductibles.

Dental insurance is not offered by all Medicare Advantage Plans, though.

Therefore, before joining, make sure to study the details of what the plan includes. If you want Medicare dental coverage, make sure the Medicare Advantage Plan you choose includes the dental services you need.

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

Original Medicare consists of medical insurance Part B and hospital insurance Part A. Only if you were hospitalized as a result of a traumatic injury that also injured your jaw, teeth, or mouth could Original Medicare cover any dental services. Then, Original Medicare might pay for a portion of the dental care.

Before an accident happens, it’s critical to understand in detail what your Medicare plan would cover.

 

Dental coverage with Medicare Supplement Insurance Policies

Dental coverage is not covered in policies that provide Medicare Supplement Insurance. These programs do, however, offer assistance with out-of-pocket costs that Original Medicare does not pay for.

Comparing dental coverage under Medicare

Here is an overview of the various Medicare plans, what they cover, and whether dental care is provided:

Benefits Information – Type of Medicare – Which Dental Coverage Options Are Available?

First-tier Medicare (Part A and Part B)

• Part A – Hospital Insurance
• Part B – Medical

No
(Except: It might be covered if hospitalized due to a serious accident that also damages the mouth, jaw, or face.)

Medicare Advantage (Part C)

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

This may also include:

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

Yes
(However, not all Medicare Advantage Plans offer dental care; make sure to review the plan’s details before enrolling.)

Medicare Supplement Insurance

Costs that Original Medicare does not cover (copays, deductibles, coinsurance)

No

 

What Medicare covers dental care services?

When it comes to Medicare and dental insurance, only Medicare Advantage Plans (Part C) may do so, and not all of them do. Usually, this coverage is fundamental and may include:

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

Read all of the fine print before enrolling in any Medicare Advantage Plan. Plans may alter depending on the insurance company and even your area. There are frequent caps on cost limits, limitations on the number of dental services that can be rendered within a plan year, and other restrictions.

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

If your Medicare coverage is functional but does not cover dental treatment, there are other choices you might take into consideration.

Buy a separate dental insurance plan

You might be able to purchase a standalone dental plan from a private insurer. There are many different dental insurance plan choices, and the majority of them have affordable monthly premiums. You might be able to find basic dental insurance with lower monthly fees that will cover preventive dental treatment. Other plans can provide more dental coverage for a small premium increase. Standalone dental plans usually feature deductibles, copays, and coinsurance.

 

Find a walk-in dental clinic

Many cities provide walk-in dental clinics that are affordably priced. Depending on where you live and the dental treatments you need, you might be able to get affordable dental care even if you have to pay out of pocket.

Check with your state department of health

On the dental health section of your state’s department of health’s website, you might be able to find details about where to get inexpensive dental treatment in your neighborhood.

Visit a local dental school

You might get in touch with any nearby dental schools or universities to ask if they provide any community members any free or inexpensive dental clinics.

Consider an HSA if you have a high-deductible plan

If you have a health plan with a high deductible, you might consider starting an HSA before you turn 65. You are still welcome to use your savings to help pay for qualifying dental treatment and other covered charges even though you are no longer allowed to make contributions to the fund once you enroll in Medicare.

Why is dental coverage important?

A healthy lifestyle includes having good dental hygiene. Not all Medicare Advantage Plans may offer the core dental coverage you require if you have Medicare, but some do. Original Medicare does not cover dental treatment.

There are other solo dental plans to consider as well. Do your homework and read the fine print of any plan before joining.

 

FAQs

What are good questions to ask about Medicare?

Use this guide to consider your options when preparing to enroll in Medicare or after you have already enrolled.

• What are the basics?
• What are your coverage options?
• Should you enroll in Part D?
• Are you eligible for programs that help lower Medicare costs?
• What resources exist to help you navigate Medicare?