Enrolling in Medicare for the first time requires a few important decisions to be made. You see, traditional Medicare plans may not cover all of the medical or dental services that you were used to having through your employer’s insurance program. The truth is, hardly any dental coverage is included at all, unless you buy into a supplemental program like the Medicare Advantage Plan.
When Dental Procedures ARE Covered Under Medicare
Basic Medicare, or “Medicare Part A” will included a very inclusive list of specific dental treatments. But, those services are only approved by Medicare if they’re performed in a hospital facility or are closely linked with medical treatments.
Very “complicated dental procedures” that cannot be performed within a general practice setting are usually the only exceptions. Severe dental emergencies that require a trip to the emergency room may or may not be included in your Medicare plan, and there’s a good chance you’ll not know until your treatment has already been rendered.
It’s up to Medicare to decide once your claim is submitted; if the service doesn’t fit their criteria, it’s rejected.
That being said, when Medicare DOES cover something dental related, it’s usually associated with:
- Treating cancer of the mouth, neck, or head
- Surgery following trauma, such as a car wreck
- Other surgeries of the jaw, treating tumors, or reconstructing broken bones
- Oral infections that require hospitalization
Fortunately, only a small percentage of people will ever have to struggle with these situations. Still, if you’re one of the unfortunate few, not having the right type of coverage can significantly impact your retirement…especially on a fixed income.
Planning ahead and being proactive about your routine dental care can reduce the cost of any “traditional” treatments that you may wind up needing, which won’t be covered under Medicare.
Specific Dental Risks For Seniors
Maybe you’ve never had dental problems in the past. But age can change things. After all, you’ve been using your teeth for years; just like a well-made machine can gradually wear out, so can your smile. That’s why dental professionals advocate routine checkups, where teeth, gums, and existing dental work can be continually monitored for changes or indication of disease.
What are some of the most common dental treatments that seniors need?
- Managing periodontal infections
- Replacing missing teeth
- Broken, cracked teeth and dental work
- Denture replacement and repair
- Bone loss (which leads to tooth loss)
What About Routine Preventive Dentistry?
Preventive dental appointments — like checkups, cleanings, and x-rays — can significantly reduce your risk of developing major dental problems that call for expensive treatment. Sadly, Medicare won’t cover your routine checkups. So it’s up to you to decide whether or not the “gamble” on your smile is worth it. Do you avoid going to the dentist? Or do you buy a supplemental plan such as Medicare Advantage and hope you can find a dentist that accepts it? Not all of them will.
Having dental benefits in addition to your Medicare plan is a smart investment toward preserving optimal oral health. Even if it’s not a high-tier plan, basic preventive dental care and discounts on restorative fillings or crowns can save you thousands of dollars in the long run.
Affordable Alternatives To Medicare Dental Insurance
If you’re planning to retire but are worried about losing your dental benefits available through your employer’s health package, an affordable alternative is to enroll in a dental savings plan. Although similar to conventional dental insurance, the two programs are very different.
With dental savings plans or “discount programs” you can enroll for coverage at any time, and keep your Medicare plan for medical care. Members can easily estimate what is or is not covered, thanks to a fixed fee schedule outlining the different types of dental treatments included in the plan. These plans are accepted by a large number of dentists and dental specialists nationwide.
At Aetna Dental Offers, we offer discount dental programs that cover 15-50% on treatments like dental cleanings, fillings, and dentures. You can enroll at any time. If you’re looking to purchase separate insurance apart from your Medicare plan, a dental savings option can offer you more flexibility and budget-friendly solutions to consider. Contact Aetna Dental Offers today for a free quote.