KEY
POINTS
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Medicare Part B covers only those dental expenses that are a part of another covered service.
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There are different types of Medicare Advantage plans (Part C), including PPO, HMO, and PFFS. Part C are private health insurance plans covering a broader array of services.
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Medigap and Original Medicare cover dental procedures and treatments in complicated situations or emergencies only, such as if a patient is hospitalized and needs oral surgery.
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It's possible to purchase plans (like stand-alone dental insurance plans and dental savings plans) outside of Medicare.
Does Medicare Cover Dental Services?
Original Medicare does not cover most of the dental procedures or supplies, such as:
- Fillings
- Dentures
- Tooth extractions
- Cleanings
- X-rays, or other dental devices.
Therefore, if you receive any dental services, you will be responsible for the full cost of dental care. However, there are other types of Medicare dental plans that cover some part of dental care and provide dental insurance for seniors on Medicare.
What Types of Medicare Plans Cover Dental Procedures?
Medicare Part A
There is limited coverage through Medicare Part A. It will cover some dental care and procedures that occur in a hospital stay. For example, if you are involved in a car accident, during which your jaw is damaged, and you have to go to the hospital, Medicare Part A may cover the reconstruction of the jaw.
In addition, Medicare Part A may cover the following procedures:
- A dental exam in a hospital.
- Dental procedures and dental care that are related to treatment for certain jaw-related diseases.
- Dental wiring and splints that are needed after jaw surgery.
- Reconstruction of the jaw if a patient had the surgery to remove a tumor from their face.
- Surgeries performed to treat fractures of the face or jaw.
It is also important to know that after the underlying health condition has been treated, Medicare will not cover any follow-up dental care.
Medicare Part B
Medicare Part B covers dental services, but it will cover only those dental expenses that are a part of another covered service. Medicare Part B dental does not cover regular dental check-ups, cleanings, X-rays, crowns, dentures, or fillings. Medicare Part B may cover the following procedures:
- Outpatient dental exams that are required before oral surgery.
- Jaw reconstruction after an accident.
- Tooth extractions that are required before radiation treatment.
- Oral exams needed before kidney transplantation.
Medicare Advantage (Part C)
Medicare Advantage plans are private health insurance plans that cover everything that Medicare Parts A and Medicare Part B cover. In addition, Medicare Advantage plans offer certain dental benefits such as coverage for:
- Dental cleanings
- X-rays
- Regular dental exams
- In some cases, there is also coverage for root canals, fillings, crowns, gum disease treatment, and dentures.
There are different types of Medicare Advantage plans, including PPO, HMO, and PFFS (Private-fee-for-service) plans. Enrollees in Medicare Advantage will likely have to pay a monthly premium in addition to the one they pay for Medicare Part B.
Medicare Supplement (Medigap)
Medicare Supplement covers certain Medicare out-of-pocket costs, including copayments, coinsurance, and deductibles. However, it is important to know that it will pay for what Original Medicare already covers. Medigap covers dental procedures and treatments in complicated situations or emergencies only, such as if a patient is hospitalized and needs oral surgery. Usually, this Medicare plan will not cover such routine dental procedures as regular check-ups, cleanings, or tooth extractions.
Purchase a stand-alone dental insurance plan
It is an insurance plan that is not included as part of a health plan and can be purchased through the Marketplace, where you can find the best dental insurance for seniors as well. Usually, people choose this plan if their health coverage does not include dental care, or if they want to have different coverage for their dental procedures. Stand-alone dental insurance plans start as low as $19 per month.
Dental discount plans
Dental discount plans, that are also called dental savings plans, are a flexible and affordable alternative to standard dental insurance. Getting a dental discount plan is like joining a dental club for your teeth, where you can get special discounts as its member. With this discount plan, you can expect savings of up to 60% on dental treatment s and procedures.
