Medicare is such a popular program because it helps cover many of its enrollees’ medical and drug-related costs. With so much covered, many wonder if Medicare covers dental care. After all, a trip to the dentist can be expensive, even if it’s just a check up on your pearly whites. Sadly, you may not even receive a discount if you’re missing teeth and using dentures, either. As one gentleman used to say, “I’m paying $80 a trip, and I have two teeth. That’s $40 a tooth!”
So, can Medicare help pay for your dentist visits? Unfortunately, if you’re covered by Original Medicare, the answer is often no. Original Medicare doesn’t cover what’s considered routine dental costs, like most cleanings, extractions, fillings, and other common procedures. It also won’t cover dental equipment like dentures or dental plates.
If you’re on Medicare, what are your dental options?
We didn’t say that Original Medicare never covers dental procedures, because sometimes, it does. These instances are extremely limited, though. Medicare Part A will cover dental services in specific situations, like if you’re in the hospital and need a procedure. For example, if you’re in a car accident and your jaw needs medically reconstructed, Original Medicare may cover the surgery. It may also cover a dental exam you need for a surgery.
If you need a dental service for something that would otherwise be covered by Original Medicare, the dental procedure MAY be covered.
Essentially, if you require a dental procedure for something else that Original Medicare normally covers, there is a chance it may be covered. Before expecting coverage, double-check on the specific circumstances of your situation in your plan or contact your dental office (who may be able to help you). Medicare Supplement, or Medigap, plans may also help pay for dental expenses by assisting with Original Medicare deductibles and coinsurances.
If you’re looking for a Medicare plan that includes more traditional dental coverage, you may want to enroll in a Medicare Part C, or Medicare Advantage, plan. These plans will often include coverage for dental procedures, checkups, and services, including preventative dental cleaning, dental x-rays, fluoride treatments, oral exams, diagnostic services, and more.
It’s important to check the fine print of your plan to see exactly what dental procedures are covered.
Coverage for major dental services, like crowns and dentures, is usually not included in Medicare Advantage plans, however. For this reason, it’s important you check the fine print of your plan to see what dental benefits it does include.
Interested in finding a Medicare Advantage plan that includes dental coverage? Try the Medicareful Plan Finder tool by clicking on one of the orange “Find Your Plan” buttons on this page. By inputting your zip code, you can see what Medicare Advantage plans are near you. From there, you can see if the plans cover dental services by viewing the plan details button for each plan. You can also see what’s covered and how much, if anything, you’re expected to pay for services.
Getting More Dental Coverage
Similar to your insurance situation prior to joining Medicare, you can join a stand-alone dental insurance plan.
If you want to keep your Original Medicare coverage or want more dental coverage than what your Medicare Advantage plan can provide, you do have another option. Similar to your insurance situation prior to joining Medicare, you can join a stand-alone dental insurance plan.
There are also dental plans that offer vision and/or hearing benefits as well. Different plans have their own pros and cons, so it may help to meet up with a licensed insurance agent to see what plans are available near you.
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A trip to the dentist can be expensive. In 2013, Americans spent an average of $544 on out-of-pocket dental expenses. A person’s yearly costs can skyrocket if they need anything beyond regular checkups. Even a single silver filling can cost an average of $132, and that’s for one filling. Getting this kind of filling is also one of the least expensive dental procedures. This is why some form of dental coverage can be beneficial for seniors.