What Medicare Plans Included Dental Benefits?
Dental coverage is a big cavity in the Medicare program. Most of the time, Medicare won’t pay for your dentist visit. Here are some exceptions:
- If you join a Medicare Advantage (Medicare Part C) plan, it probably has some form of dental coverage.
- Medicare Supplement plans may come bundled with a stand-alone dental plan.
- Affordable stand-alone dental plans for people with Medicare are very popular.
- Other government programs may take your dental needs into account.
Dental Work That Is Covered by Basic Medicare
Does Medicare cover dental care at all? If oral work must be performed to address a different health issue – that is, if it is primarily medical and not strictly dental – then Medicare may step in. Medicare may pay for dental work if your dental health is so severe that it is a major contributor to hospitalization, your hospitalization is the result of a dental procedure, it’s an integral or incidental part of a covered procedure, such as to prep for radiation treatment or remove a tumor, it’s part of a jaw injury or similar issue, or it’s an examination (but not treatment) before a kidney transplant or heart valve replacement, so as to prevent issues during your surgery.
Dental Work Not Covered by Basic Medicare
Dental work has been excluded from Medicare since the start of the program in the 1960’s. It’s a total exclusion, not just specific procedures. Medicare does not cover routine fillings, whitenings, cleanings, extractions, dentures, root canals, crowns and implants.
And costs can add up, especially for major work. Out-of-pocket costs for dentures and dental implants, for instance, can be anywhere from $300 per tooth to $1,500 or significantly more for a full set of dentures.
Dental Coverage on a Medicare Advantage Plan
Medicare Advantage plans (Medicare Part C) are different from Original Medicare. They can add important additional benefits, like dental care, to your Medicare coverage.Sometimes these benefits are automatically on your plan. In other cases, you may have to request them from your insurer.
Medicare Advantage Dental Rules: When you see the dentist on Medicare Advantage, you may have to pay some costs on your own. There will probably be additional rules, like a maximum number of visits or poor coverage for costly procedures. You may have a relatively low maximum annual benefit – enough to get regular cleanings and a set of dentures, but not enough for unlimited dental work.
Expect limited help from your plan even if other medical procedures are well-covered. Medicare Advantage plans must have equal or better coverage as Original Medicare for benefits that are in Part A and Part B. However, Medicare Advantage plans create their own limits on dental coverage.
Dental Coverage on a Medicare Supplemental Plan
Medicare Supplement can only help you save on Medicare Part A and B care. Since dental work isn’t covered by Original Medicare, your Medicare Supplement plan can’t add on extra benefits like dental coverage.
Some Medigap providers do offer separate discount programs or special offers on their own private coverage as an additional, optional benefit. Look to your Medicare Supplement provider for more details.