Medicare provides health insurance for over 55.3 million people. But what about dental insurance? Many recipients have questions about what, if any, dental procedures are covered by Medicare. Here’s a closer look at what’s covered, what isn’t and what other options you have for affordable dental care.
What is Medicare?
Medicare is a federal health insurance program which serves people over the age of 65 as well as younger people with certain disabilities. People with permanent kidney failure are also eligible. Medicare is divided into parts A through D. Services covered include hospital stays, doctor visits, prescription drug costs and more. Medicare provides coverage for preventative check-ups as well as emergency treatments. Ideally, the goal is to treat minor health problems before they turn into something major.
Does Medicare Cover Dental Procedures?
Basically, no. Most routine dental care is NOT covered by Medicare. Check-ups, cleanings, x-rays and other basic procedures aren’t covered. A lack of basic preventative care allows minor dental problems to turn into major issues.
Unfortunately, Medicare doesn’t cover most major dental problems, either. Intricate dental procedures such as extractions, periodontal treatments, denture fittings and more are also not covered.
Does Medicare Cover Any Dental Procedures… Ever?
Yes, but in a roundabout way. Typically, Medicare Part A will pay for some emergency dental procedures when dental treatment is necessary as part of a procedure that Medicare does cover. For example, if tooth extractions are required to fix a facial injury such as a broken jaw, Medicare may pay for the extractions. Medicare will not, however, pay for dental treatment to restore the extacted teeth.
Additionally, Medicare may pay for dental procedures related to oral cancers, kidney transplants, heart valve replacements and similar chronic conditions. Note that here again Medicare will usually only pay for the initial procedure. Follow-up dental care is not covered.
How Do People on Medicare Pay for Dental Visits?
Medicare recipients pay for roughly three-quarters of their dental work themselves. And some have chosen to enroll in Medicare Advantage plans that provide dental coverage. Unfortunately, over half of all Medicare recipients don’t even see a dentist at all. If you’re on Medicare, you’ll probably want to explore other options for affordable dental care.
Can I Pay Out-of-Pocket for Medical Care?
You can. In many cases, dentists offer a discount if you’re able to pay cash. Many dentists want to avoid the hassle of dealing with an insurance company.
The problem is many people on Medicare have a pretty tight budget. Paying out-of-pocket, even with a cash discount, isn’t always an option. Instead, they need a way to lower all of their dental bills. Options here include a Medicare Advantage plan, dental insurance and a dental discount plan.
What is a Medicare Advantage Plan?
Also referred to as Part C, an Advantage Plan is supplemental coverage provided by a private company which has been approved by Medicare. Plan benefits vary but some companies do offer dental coverage.
Traditional dental insurance does have some potential problems. Coverage will have a deductible and yearly coverage limit. Plus, coverage can be limited by any pre-existing conditions you may have.
If you have Medicare without any type of supplemental dental coverage, you might not have visited the dentist in quite a while. Unfortunately, any current dental problems you have are unlikely to be covered by an insurance plan you purchase today.
If you have dental problems and limited income, you’ll likely benefit from multiple discounts on dental services which you need, regardless of when the problem developed. Instead of dental insurance, you might want to consider a dental discount plan.
What is a Dental Discount Plan?
Also known as a dental savings plan, a discount plan works like a membership club for dental savings. As a member, you present your discount card for immediate savings right at the dentist’s office.
You can see savings between 15% and 50%. Specific discounts vary based on the procedure, the particular dental discount plan, and other factors but there is no annual spending limit, waiting periods or restrictions on getting discounted care for existing dental problems.
What’s the Best Option for Dental Coverage?
Medicare is often a literal lifesaver for many people who otherwise wouldn’t have health insurance. But Medicare isn’t a great way to maintain your dental health. Almost no dental procedures are covered.
In many cases, a dental discount plan offers the widest variety of discounts for someone on Medicare. The discount plan lets you fix on-going dental problems quickly, and get the regular care you need to avoid new dental problems. Medicare for health, and a dental discount plan for dental health, is often a winning combination.