Medicare Blog

how to find a medicare plan that offers dental benefits

by Trystan Strosin Published 3 years ago Updated 2 years ago
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Find Dental Plans for Medicare Near You
Good resources include the State Health Insurance Assistance Program at 877-839-2675 or call Medicare at 800-MEDICARE (800-633-4227) to get answers to questions not answered in your research.

Which Medicare Advantage plans cover dental?

The Modern Medicare Agency offers dental options that go beyond employer coverage. Dental insurance is especially important to ... Also, clients can take advantage of various amounts of tax-deferred growth. Agent Paul Barrett decided to pursue a license ...

How do I get dental coverage with Medicare?

​​​Medi-Cal Dental Program

  • Diagnostic and preventive dental hygiene (e.g. ...
  • Emergency services for pain control;
  • Tooth extractions;
  • Fillings;
  • Root canal treatments (anterior/posterior);
  • Crowns (prefabricated/laboratory);
  • Scaling and root planning;
  • Periodontal maintenance;
  • Complete and partial dentures; and
  • Orthodontics for children who qualify.

Why you should have dental insurance as a retiree?

Retirees and seniors

  • Help mitigate common problems: Gum disease (68%) and dry mouth (30%) are widespread among Americans 65 and older. ...
  • Get access to quality dentists in your area: More than 1 in every 4 seniors have not visited their dentist in the last five years. ...
  • Maintain your overall wellness: Studies show a strong correlation between dental health and overall health.

More items...

Does Medicare Advantage cover dental care?

The good news is that, while Original Medicare coverage does not provide benefits for dental care, Part C Medicare Advantage plans usually do offer a benefit for checkups, screenings, fillings and other routine dental care needs. Medicare Advantage plans are required to include the same benefits as Part A and Part B, but many include additional coverage, including dental services.

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Learn more about your benefits

Tanya Feke, MD, is a board-certified family physician, patient advocate and best-selling author of "Medicare Essentials: A Physician Insider Explains the Fine Print."

Does Medicare Cover Dental Care?

When it comes to Medicare, you have two main options. You can either enroll in Original Medicare or a Medicare Advantage plan. You cannot have both. Understanding the difference is important when it comes to dental care.

What Is Medicare Part B Dental?

Unfortunately, Medicare Parts A and B do not cover preventive dental care like routine exams, cleanings, root canals, extractions, or X-rays. They will only cover specific dental services required for other medical procedures or conditions.

Low-Cost Dental Options

According to an analysis by the Kaiser Family Foundation, nearly half of Medicare enrollees go without dental coverage. Of those who do have coverage, only 29% get it from a Medicare Advantage plan, and they spent an average of $874 in out-of-pocket costs in 2018. One in five of them spend more than $1,000 each year. 9

Summary

Medicare Parts A and B dental coverage is limited, and many people turn to Medicare Advantage plans for dental benefits. Those benefits vary from plan to plan and are often limited by a cap on spending.

A Word From Verywell

Dental health is important to your overall health. Don’t let dental coverage pass you by. You may need to be proactive and look for low-cost options where you live. Many organizations offer coverage for older adults.

What are the complications of dental care for Medicare?

6 Just a few of the complications that can be associated with poor dental hygiene include: Diabetes. Heart disease.

What is Medicare Advantage?

A Medicare Advantage plan provides all the same coverage as Original Medicare (except for hospice care, which you still receive from Medicare Part A). In addition to covering the same benefits as Original Medicare, some Medicare Advantage plans may offer additional benefits such as: Dental. Hearing. Vision.

What is Medicare Part A and Part B?

While Medicare Part A and Part B (often called Original Medicare) provide coverage for a wide range of health care benefits, one of the few areas in which it comes up short is routine dental care.

How much does a root canal cost?

Root canals. Front tooth: $300 to $1,500. Bicuspid: $400 to $1,800. Molar: $500 to $2,000. When you add it up, simply visiting the dentist every six months for a routine dental exam and teeth cleaning could cost over $700 a year, and that’s not taking into account any necessary fillings or procedures.

How much does it cost to remove wisdom teeth?

Surgical (the tooth is covered by gum or bone): $150 to $650. Simple wisdom tooth removal: $75 to $200 per tooth. Pulling four wisdom teeth in one appointment: $1,000 to $3,000.

Does Medicare cover dental insurance?

Original Medicare does not provide coverage for most dental care. Part A (hospital insurance) will cover certain dental services that are administered in a hospital and may provide some coverage for emergency dental care or complicated dental procedures. Routine care like cleanings, extractions and fillings, however, are not covered.

How We Chose the Best Medicare Supplemental Dental Plans

With all the Medicare Advantage plans on the market, it can be difficult to compare your options. We came up with our list of Medicare Advantage plans for best dental coverage by researching and comparing nationwide availability, pricing, plan options, and additional benefits.

Does Medicare Cover Dental?

Original Medicare, referred to as Medicare Part A and Medicare Part B, only covers dental issues that happen in the hospital. This means it covers dental issues under emergency situations resulting from accidents or oral cancer-related problems. Traditional Medicare does not cover routine dental exams, cleanings, and X-rays.

Do All Medicare Advantage Plans Cover Dental?

The short answer to this question is no, not all Medicare Advantage plans cover dental.

What Do Medicare Advantage Dental Benefits Cover?

Medicare Advantage plans with dental coverage generally have preventive coverage and comprehensive coverage. Preventive coverage refers to general dental checkups every six months and includes dental exams, X-rays, and cleanings.

What dental care does Medicare Advantage cover?

Medicare Advantage dental coverage may be as basic as annual cleanings and X-rays, or a plan may cover more comprehensive services like extractions and dentures.

How much does dental care cost with Medicare Advantage?

Dental costs on a Medicare Advantage plan will vary by plan and by service. Some plans require a copay or coinsurance for every service. For instance, if there’s 50% coinsurance (the most common setup) required for a filling, you would pay 50% of the cost.

What if you have Original Medicare?

If you have Original Medicare, you’ll need to buy a separate dental insurance policy to cover your dental needs or pay out of pocket for dental care. Many of the Medicare Advantage providers also sell separate dental policies, or you can look for policies with companies like Delta Dental, Liberty, Spirit Dental or Guardian.

How to shop for Medicare Advantage plans

Medicare Advantage plans aren’t just about dental coverage — you’ve got to get the right coverage for all of your health care. Here are some strategies for finding the best plan for you:

Medicare Advantage

Medicare Advantage is private insurance available through Medicare. It’s an alternative to Original Medicare Parts A and B, and many Advantage plans provide expanded offerings beyond traditional Medicare coverage.

Supplemental Dental Insurance

You don’t have to get dental coverage through Medicare. One alternative is purchasing a private dental insurance policy designed specifically for Medicare recipients.

In-Hospital Dental Coverage

According to the U.S. Centers for Medicare & Medicaid Services, while Original Medicare won’t cover routine or basic dental care, it will cover certain dental services that you may need while hospitalized. Original Medicare Part A will also cover an inpatient hospital stay for emergency or complex dental procedures.

Paying Out of Pocket

You can also consider paying for dental care out of pocket by setting aside a set sum of money each month or joining a local dentist’s care plan.

Get Started Now

Interested in learning more about Medicare, Medigap, and Medicare Advantage plans? WebMD Connect to Care Advisors may be able to help.

Dental Benefits Provided by Medicare Advantage Plans

Routine dental coverage is available with most Medicare Advantage plans, with a $0 copay* for preventive services with in-network dentists. Plans will offer different levels of dental care—from preventive and diagnostic services only, to more comprehensive dental coverage.

Dental Networks and Costs

In most locations, Medicare Advantage plans with dental coverage are supported by the UnitedHealthcare Dental National Medicare Advantage Network.* This is the largest Medicare Advantage dental network1, and by choosing to see a dentist in our robust network, you may take advantage of substantial savings.

What you should know

Original Medicare does not provide dental coverage except for certain services received while in the hospital.

What Does Medicare Advantage Dental Cover?

Medicare Advantage Plan dental coverage varies by plan. It can be anywhere from as little as two cleanings per year to an annual allowance of up to $2,000, Pruemm says. Medicare Advantage dental coverage usually includes cleanings, routine x-rays, extractions and fillings. However, a prior authorization or advance approval is usually required.

Which Medicare Advantage Plans Offer Dental Coverage?

Not all Medicare Advantage Plans offer dental coverage. When they do, the services can vary greatly, even within companies. “A company may offer dental in one state, but not another,” Hill says.

What is Medicare Advantage Dental?

Understanding Medicare Advantage dental coverage. Dental care is a vital part of maintaining your health and well-being, especially as you age. And one of the main perks of joining a Medicare Advantage (MA) plan is that many plans offer dental coverage to help you keep up with your oral health.

How long does it take for Aetna to reimburse you for dental care?

You’ll pay for your dental care up front when you see a dentist, and then submit your receipts to Aetna to get reimbursed within four to six weeks. “With a direct member reimbursement allowance, you’re given a set amount of money to spend each year on dental care.”.

How long do you have to enroll in dental insurance in MA?

Members must enroll in this option when they enroll in their plan, or within 30 days of their plan’s start date.

Does Medicare cover dental cleanings?

Original Medicare, on the other hand, does not cover routine dental care, such as cleanings, X-rays, and fillings. Due to the relatively high out-of-pocket costs for these procedures, some older adults end up forgoing necessary dental care. There is one exception, however: If you need medical dental procedures while you’re in the hospital, ...

Can you go out of network with PPO?

For PPO plans, you have the option to go out of network, but you will have higher costs. All preventive services (cleaning, X-rays, exams) are covered at 100%. For comprehensive services, you’ll pay a portion of the cost (coverage varies by plan). You may have an annual plan maximum.

Does Aetna have dental insurance?

Dental benefits are already included in the majority of Aetna MA plans. For some Aetna MA plans that don’t include dental coverage, you may have the choice of paying extra each month for dental benefits. This is done through an optional supplemental benefit.

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