Does Medicare Insurance Plan Cover Dental Care Services?


Mohit Kamboj

Medicare is a federal government health insurance plan covering people beyond 65 years and people with disabilities. Currently, the program covers more than 65 million US citizens. This insurance policy covers many diseases, but there are some exemptions. Knowing what plans cover dental care and your options is essential if you are more concerned about your oral health.

Types of Medicare plans Available

There are three main Medicare plans available, and they have different operation practices. Depending on your needs and budget, you can choose either of the following plans.

  • Medicare Part A. this plan covers admitted patients in a hospital, nursing home, or hospice service. It does not protect dental care services.
  • Medicare part B: it is a plan that covers both inpatient and outpatient services. Unlike Medicare part A this plan covers dental care procedures that are an integral part of another procedure.
  • Medicare Part C: it is also referred to as Medicare Advantage. This plan covers all the expenses covered in Medicare Part A and B, and in addition, it offers some dental care services. However, some parts of this plan need the enrollees to pay a monthly premium to get all benefits.

Does Medicare Health Insurance Cover Dental Care?

There are a few main options in the Medicare Plans available to the applicants. It is thus important to first understand them before choosing a good plan because you cannot have both of them. You can have a Medicare Advantage plan or original Medicare. Understanding how these plans work is essential when it comes to dental care.

As its name suggests, Original Medicare was the first insurance plan that came into existence when the Social Security Amendments were passed and put into practice in 1965. This plan has Medicare part A and Medicare part B, and they all cover different healthcare services.

In addition, a new Medicare plan was developed in 1997, and it was referred to as the Medicare plan C. Initially, the plan was referred to as the Medicare +Choice. The name of Medicare Plan C changed in 2003, and since then, it has been referred to as Medicare Advantage.

Medicare Advantage covers everything covered by the Original Medicare, but the main difference is that insurance companies govern this plan. On the other hand, the Federal government runs the Original Medicare plan. The private insurance companies that run Medicare plan C can offer additional services referred to as supplemental benefits not provided in the Original Medicare plan.

For enrollees to get extra services when using the Medicare Advantage service, they must pay an additional premium. Medicare Advantage remains the best Medicare insurance plan to get dental coverage. However, not all programs offer dental coverage, and it is thus essential to read and understand your plan details.

The Original Medicare insurance plan may cover dental care but in limited circumstances. On the other hand, the Medicare Advantage plan may offer routine dental care as a supplemental benefit. You can choose a Medicare Advantage plan that covers dental care and fits your needs and budget.

The plan you choose can include a wide range of dental care services, including tooth extraction, filling, dentures, routine dental cleaning, crowns, and bridges. Most plans limit the amount of money they would use to cover dental care. It is thus essential to contact your insurance care provider to understand the terms of the plan you are using.

Medicare Part B Dental

Medicare parts A and B will not cover preventative dental care procedures like tooth extraction, routine cleaning, root canal, and dental X-rays. However, Part B of this plan will cover dental problems that are integral to the covered procedure. An example of this cover includes but is not limited to treatment procedures aiming to reconstruct a jaw that may be accidentally damaged.

In addition, the Original Medicare plan part B will cover tooth extraction procedures that may be done in preparation for radiation treatment for a neoplastic disease that involves the jaws. Moreover, this plan will cover teeth extraction but not treatment in patients undergoing kidney transplants or other exceptional cases like heart valve replacement procedures.

On the other hand, Original Medicare part A is also referred to as hospital insurance. It is a plan that covers the services you receive when you are admitted to a hospital or the care you get from other facilities like the home health service, hospice care, and skilled nursing institution.

However, this insurance plan rarely covers dental care services. It may cover various cases, for example, when you are brought to a hospital for an emergency or other complex dental procedures like jaw reconstruction surgery following an accident.

How Much Does Dental Coverage Cost

The cost of dental care in the Medicare advantage plan where you need to add an extra premium, varies based on your age, physical location, and the problem being treated according to this website. For example, in Eastern Pennsylvania, the Medicare Advantage premium varies from$0- $302 every month. In Los Angeles, the same plan range from $0-$397.

Low-cost Medicare Advantage plans do not include a monthly premium for dental coverage. Thus these plans only cover basic dental procedures like monthly checkups and cleaning. Therefore when enrollees of this plan suffer from a more complex dental problem, they have to pay for treatment themselves or use other private insurance policies to cover treatment.

More expensive Medicare plans require you to pay more monthly premiums for them to cover more complex dental procedures. It is thus essential to assess different Medicare Advantage plans and choose the one that serves your needs and the one that is best for your budget.

How to Enroll In a Medicare Plan that Includes Dental Insurance

You can enroll in a Medicare plan anytime, provided you are eligible for the Medicare or during the open enrollment period that takes place from October 5th to December 7th. The enrollment process requires you to visit the Medicare plan website and enter your ZIP code to see all the eligible plans and whether they include dental care benefits.

On the website, every Medicare plan has a summary of all the benefits you can enjoy while using this plan. It is thus vital to attentively read and understand the insurance plan before enrolling in it. If you fail to understand, you can directly contact the management or seek help from professionals who understand the policy.

How to Get Dental Coverage if Your Medicare Plan Does not Include It?

If the Medicare you currently have does not provide dental care services, other options to consider are helpful. Studies have shown that most people who qualify for Medicare services have more complex dental problems. These problems worsen because they are not covered in the plans they have. Below are some options you may consider:

Enroll in a Separate Dental Plan in a Different Insurance Company

There are many dental plans in the United States to choose from, and they have pocket-friendly monthly premiums. These cheap dental coverage plans may offer preventative dental care at a lower price. On the other hand, other dental care coverages offer advanced coverage at relatively higher premium rates. It is thus essential to choose the insurance cover that serves your needs.

Look for Affordable Dental Clinics in Your Area

Many dental clinics offer both preventative and advanced dental care services at an affordable price in every state. It is thus essential to visit these institutions to have regular dental checkups and treatments, even if you will have to pay for these services with your money. These practices will ensure a healthy dental life, and you won’t depend on Medicare insurance plans.

Look For Dental School or University Program Nearby

Dentists, during their training period they need to gain real-life experience to help them in their career lives. For this reason, many dental schools and universities partner with dental clinics, and they offer dental care services at an affordable price and, in some cases, free of charge. It is thus essential to look for these kinds of programs and have your dental health checked and treated.

Check with Your State’s Health Department

It is essential to look for low-cost dental services offered by the State governments. Most of these services are advertised on the government’s website, and you can always take advantage. These government-funded services offer both primary preventative dental care and complex dental treatment procedures.

Open a Health Savings Account

Before you are 65 years old, you can open a Health Saving Account (HSC) and start having security savings that you will use to cover some health problems. Having this kind of an account ensures that you can get even dental care services that the Medicare insurance plan does not cover.

Bottom Line

Oral health and hygiene an essential parts of having a healthy life. If you are looking for dental coverage in Medicare plans, only some Medicare plans offer dental coverage. The original Medicare plan does not offer dental care coverage at all. It is thus vital to choose the best Medicare Advantage plan that covers dental health or select one of the standalone dental plans available.