Dental

Dental

MEDICARE COVER DENTAL?

The world of Medicare can be confusing when it comes to what’s covered by the different types of Medicare. If you’re focused on taking care of your oral health, then it’s important to know if Medicare covers dental and if not, what options are available to you.

Does Medicare cover dental care?

Yes and no. Original Medicare doesn’t cover most dental care. If you’re shopping for coverage for routine dental care, such as teeth cleaning and X-rays, and other dental care for fillings, extractions, dentures, and more, then Original Medicare doesn’t cover those things. However, there are ways to obtain dental coverage under some types of Medicare plans.

What type of Medicare covers dental?

Medicare Advantage Plans, sometimes called Part C, combine Original Medicare Part A and Part B into one complete plan. These plans are offered through private insurance companies approved by the government Medicare program. These plans may also offer extra programs and services not covered by Original Medicare, such as dental coverage. Some plans may also include Part D prescription drug coverage and vision.

Medicare Advantage Plans work similarly to traditional health plans in cost and coverage. For example, there are HMOs, PPOs, POS plans, and more. They can include deductibles, copays, and coinsurance. But not all Medicare Advantage Plans cover dental. So before you sign up, make sure to read the details of what the plan covers. If you want dental coverage under Medicare, then make sure the Medicare Advantage Plan you choose includes the dental coverage that fits your needs and budget.

Does Original Medicare, Part A and Part B, cover dental?

Original Medicare is composed of Part A, which is hospital insurance, and Part B, medical insurance. The only instance in which Original Medicare might cover any dental work, is if you suffered a traumatic injury that also affected your jaw, teeth, or mouth and had to be hospitalised. Then, Original Medicare may cover some of that dental care. Understanding exactly what your plan would cover is important to know before accidents occur.

What dental services are covered by Medicare?

When it comes to Medicare and dental coverage, only Medicare Advantage Plans (Part C) may offer dental coverage and not all of them do. This coverage is typically basic and could include:

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

Make sure to review all details of any Medicare Advantage Plan before you enroll. Plans may differ based on the insurance company and even your location. Dental coverage often comes with limits on how many services are covered in a plan year, maximum cost allowances, and more.

Dental coverage under Medicare: Comparison table

In summary, here are the types of Medicare, what they cover, and if dental coverage is available:

Type of Medicare
What’s Covered
Dental Coverage Available?

Original Medicare (Part A and Part B)

  • Part A – Hospital Insurance
  • Part B – Medical

No
(exception: may be covered if hospitalized due to a serious accident that also affects mouth, jaw, face)

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
(Not all Medicare Advantage Plans include dental, however; check plan details before enrolling)

Medicare Supplement Insurance

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

No

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

If you’re on a Medicare plan that’s working for you and doesn’t offer dental coverage, there are other options you may consider:

  • Buy a separate or standalone dental plan from a private insurance company. There are many types of dental plans to choose from, usually with affordable monthly premiums. Basic dental plans may offer you coverage for preventive dental care with lower monthly premiums. Other plans may provide more dental coverage for a little higher premium. Standalone dental plans usually include deductibles, copays, and coinsurance.
  • Look for an affordable walk-in dental clinic in your area. Depending on where you live and what kind of dental services you need, you may be able to find affordable dental care even if it means paying out-of-pocket.
  • Check with your state department of health. They may have information on where you can get low-cost dental services.
  • Have a local dental school or university program nearby? You can contact them to see if they offer any free or low-cost dental clinics.
  • Before age 65, you can consider opening a Health Savings Account (HSA) if you have a high deductible health plan. Once you enroll in Medicare you can no longer contribute to the fund, but you can certainly use what you’ve saved to help pay for covered expenses, including eligible dental care.

Oral health is an important part of living a healthy life. If you’re looking for dental coverage under Medicare, some kinds of Medicare Advantage Plans may offer basic dental coverage, but not all. Original Medicare doesn’t include dental. There are also plenty of standalone dental plans to consider. Shop carefully and make sure to read the details of any plan before you enroll.

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