Does Medicare Include Dental Coverage?

When it comes to dental care, you might ask yourself “Does Medicare Include Dental Coverage”?  Many people new to Medicare are surprised to find that Medicare doesn’t cover routine dental services. Except for some limited circumstances, you’ll be on your own to find coverage for keeping your teeth healthy.  Back in the 60’s when Medicare was being created, the American Dental Association opposed the inclusion of dental care into Medicare. Although times have changed, and dental care is now a normal part of most insurance, Medicare has simply never been updated.

Medicare does not provide any coverage whatsoever for all of the things that you and I tend to commonly associate with dental coverage. You’ll pay for your own oral exams and cleanings as well as any basic and major services. Even dentures are not covered.

Medicare’s Limited Exceptions for Dental Care

While routine coverage is not provided, Medicare does provide limited care in circumstances of illness or injury. For example, if you were in an accident or had a disease that caused you to need a repair to your jaw, Medicare may cover the reconstruction. Medicare will also cover preventive oral exams before you have a heart transplant or kidney transplant.  Sometimes Medicare provides related coverage that falls under Part A or B. For example, if you needed to stay in the hospital for an emergency dental procedure, Medicare might cover the hospital stay but not the dental surgery or procedure.

These situations are all very rare, so it’s best to just consider dental care as something that almost always falls outside of Medicare’s protection and coverage.

Ways to Get Dental Coverage

If you have been asking yourself ” Does Medicare Include Dental Coverage?”  We want you to know that although Medicare itself doesn’t provide routine dental care, there are a number of ways that you can obtain some coverage.

  • Medicare Advantage Plans

In the 1990s, Medicare Advantage plans were created as an alternative to Original Medicare and Medigap. These plans are offered by private insurance companies that usually have networks. You will get your Part A and B covered services through the plan instead of directly from Medicare.  Advantage plans are allowed to include ancillary benefits that are not found under Original Medicare. This includes routine dental, vision and hearing services. Each plan has a Summary of Benefits which you can review to see what preventive or routine dental services that the plan might provide. Most of the time there will be a network of dentists from whom you must receive that care. You are eligible to enroll in a Medicare Advantage plan in you live in the plan’s service area and you are enrolled in Medicare Parts A and B. There is only one health question about End Stage Renal Disease. If you want to investigate this coverage, then give our office a call.

  • Standalone Private Dental Insurance

The private insurance market offers a number of great carriers from whom you can purchase dental coverage. You can find inexpensive HMO or PPO dental plans. Many plans cover the regular services that you are used to having, such as oral exams and teeth cleaning and x-rays. Most of the time you will owe a small deductible each year before you benefits kick in. Check your dental plan’s outline of coverage to also learn what copays, coinsurance, or other out of pocket spending you should be prepared for when you use your coverage. In some cases, you can find dental insurance bundled with vision and hearing coverage. Since Medicare doesn’t cover routine vision or hearing services either, these types of plans make a great option for many Medicare beneficiaries.

  • Dental Discount Card 

Some organizations and insurance companies have created dental discount programs. This is essentially a network of dentists who have agreed to treat you at reduced rates when you show your discount card. Discounts plans tend to be very inexpensive, so they can be a great option if you have a limited budget.  Just keep in mind that since discount cards don’t provide true insurance, your fees for major services like a crown, root canals, and other major services can be considerably more than what you would pay if you had real dental insurance.

Contact us for additional details on options in the Kansas and Missouri area or If you have been asking yourself ” Does Medicare Include Dental Coverage?”  

 

 

 

 

Danielle Kunkle Roberts is the co-founder of Boomer Benefits in Fort Worth, TX.

 

 

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