Medicare is a complex system that can be difficult to navigate. Trying to figure out your dental care coverage under Medicare can be a frustrating and time-consuming process.
Knowing whether or not Medicare provides coverage for dental is crucial if you have an interest in maintaining good oral health. Think about the many Medicare options and how they might or might not cover your dental care.
Does Medicare cover dental care services?
Well, sort of. Most dental treatment is not covered by Original Medicare, and you cannot supplement it with a Medicare dental plan. Original Medicare doesn’t pay for any dental care, so you’ll need to look elsewhere if you need fillings, extractions, dentures, or other advanced dental work. Medicare does not often cover dental treatment, but there are options for becoming covered.
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What are some types of Medicare dental coverage?
Medicare comes in a variety of flavors, and plans’ dental coverage varies widely.
Dental coverage with Medicare Advantage Plans
Part C, or Medicare Advantage, plans bundle together Original Medicare’s Parts A and B. The Medicare program contracts with private insurance firms to provide these options. Extras, such as dental coverage, may be included in these plans that aren’t available with Original Medicare. Vision and Medicare Prescription Drug Coverage (Part D) may be included in some plans.
Medicare Advantage Plans operate in a fashion analogous to conventional health insurance programs, both in terms of cost and scope of services provided. Health maintenance organizations (HMOs), preferred provider organizations (PPOs), point of service (POS) plans, and many others exist. Copayments, deductibles, and coinsurance are examples.
However, dental care may not be included in all Medicare Advantage Plans.
Read the fine print of the plan’s coverage before committing to it. Make sure the Medicare Advantage Plan you select includes the dental care services you require if you are seeking Medicare dental coverage.
Dental coverage with original Medicare, Part A and Part B
Both hospital insurance (Part A) and medical insurance (Part B) make up Original Medicare. Original Medicare will not pay for dental care unless you have been hospitalized due to an accident that also caused damage to your jaw, teeth, or mouth. It’s possible that part of your dental care costs will be reimbursed by Original Medicare.
It’s crucial to know what your Medicare plan covers before anything happens.
Dental coverage with Medicare Supplement Insurance Policies
Dentist care is not covered by Medicare Supplement Insurance. However, these plans do assist with costs that aren’t covered by Original Medicare.
Comparing dental coverage under Medicare
In summary, these are the varieties of Medicare, what they cover, and if dental coverage is available:
|
Type of Medicare
|
What’s Covered
|
Dental Coverage Available?
|
|---|---|---|
| Medicare as it was originally conceived (Part A and Part B) |
|
No (with one possible exception: hospitalization due to a catastrophic injury that also affects the mouth, jaw, or face, which would necessitate oral surgery) |
|
Medicare Advantage (Part C)
|
May also include:
|
Yes (Check your Medicare Advantage plan’s terms to see if dental coverage is included before signing up.) |
| Supplemental Health Insurance for Medicare | Expenses that are not paid for by Basic Medicare (copays, deductibles, coinsurance) |
No
|
What dental care services are covered by Medicare?
Only Medicare Advantage Plans (Part C) are allowed to provide dental coverage, and not all of them do. This is the bare minimum, and it may cover things like:
- Teeth cleaning
- Routine X-rays
- Extractions
- Fillings
- And possibly more
Before signing up for a Medicare Advantage Plan, be sure you understand everything about the plan. Insurance companies and regions may each provide slightly different plans. Limits on the number of covered dental services each plan year, maximum out-of-pocket costs, and other restrictions may apply.
How do you get dental coverage if Medicare doesn’t include it?
The Medicare plan you’re currently enrolled in may not cover dental treatment, but you do have choices.
Buy a separate dental insurance plan
You can acquire a standalone dental plan from a private insurance firm. There are many types of dental insurance plans to choose from, usually with cheap monthly costs. Basic dental plans may offer you coverage for preventive dental care with reduced monthly premiums. Other plans may provide more dental coverage for a little higher rate. Deductibles, copayments, and coinsurance are common features of stand-alone dental plans.
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Find a walk-in dental clinic
Affordable, walk-in dental clinics are available in many major cities. It’s possible, while it depends on your location and the specifics of your dental care needs, to discover reasonably priced dental services on your own.
Check with your state department of health
There may be resources for low-cost dental treatment in your area listed on the state health department’s oral health page.
Visit a local dental school
Get in touch with any local dentistry schools or university dental programs to find out whether they provide community dental care at reduced or no cost.
Consider an HSA if you have a high deductible plan
If you have a high deductible health plan and are under 65 years old, you may want to start a Health Savings Account (HSA). When you sign up for Medicare, you can no longer make contributions to the fund, but you can use the money you’ve saved to pay for Medicare-approved dental care and other eligible expenses.
Why is dental coverage important?
It’s crucial to take care of your teeth and gums if you want to be healthy overall. Some, but not all, Medicare Advantage Plans provide at least some dental benefits for Medicare beneficiaries. There is no coverage for dental treatment under the original Medicare plan.
Independent dental plans are also plentiful. When enrolling in a plan, do your research and comparison shopping thoroughly.
