Does Medicare Include Dental Coverage?

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, a beneficiary may not even receive a discount if they are 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 beneficiaries’ dentist visits? Unfortunately, if they are 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 will not cover dental equipment like dentures or dental plates.

If a beneficiary is on Medicare, what are their dental options?

Original Medicare

Original Medicare can sometimes cover dental procedures. These instances are extremely limited, though. Medicare Part A will cover dental services in specific situations, like if a beneficiary is in the hospital and needs a procedure. For example, if a beneficiary is in a car accident and their jaw needs to be medically reconstructed, Original Medicare may cover the surgery. It may also cover a dental exam they need for a surgery.

Essentially, if a beneficiary requires a dental procedure for something else that Original Medicare normally covers, there is a chance it may be covered. Before expecting coverage, beneficiaries should double-check on the specific circumstances of their situation in their plan or contact their dental office (who may be able to help them). Medicare Supplement, or Medigap, plans may also help pay for dental expenses by assisting with Original Medicare deductibles and coinsurances.

Medicare Advantage

If beneficiaries are looking for a Medicare plan that includes more traditional dental coverage, they 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. Coverage for major dental services, like crowns and dentures, is usually not included in Medicare Advantage plans, however. For this reason, it’s important they check the fine print of their plan to see what dental benefits it does include.

Getting More Dental Coverage

If a beneficiary wants to keep their Original Medicare coverage or wants more dental coverage than what your Medicare Advantage plan can provide, they do have another option. Similar to their insurance situation prior to joining Medicare, they can join a stand-alone dental insurance plan. There are also dental plans that offer vision and/or hearing benefits. Different plans have their own pros and cons, so it may help for beneficiaries to meet up with a licensed insurance agent to see what plans are available near them.

A trip to the dentist can be expensive. Americans spent an average of $625 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 up to $150, 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.

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