Original Medicare doesn’t cover most dental care, including dental exams, teeth cleanings, fillings, root canals, extractions, dentures, implants and crowns. However, you may be eligible for some services covered under Medicare Part A — your hospital insurance. Advertisement How does Original Medicare cover dental?
Full Answer
Which Medicare Advantage plans cover dental?
Medicare doesn't cover most dental care (including procedures and supplies like cleanings, fillings, tooth extractions, dentures, dental plates, or other dental devices). Medicare Part A (Hospital Insurance) will pay for certain dental services that you get when you're in a hospital. Part A can pay for hospital stays if you need to have emergency or complicated dental procedures, …
How can I get dental coverage with Medicare?
AARP dental plans for seniors: Delta Dental also administers affordable dental insurance plans through AARP. With this membership-based program, seniors can reap the benefits of a comprehensive dental plan that extends beyond basic dental care to meet the typical dental care needs of people 50+.
How does Medicare actually cover dental treatment?
· The overwhelming majority of Medigap plans don't cover dental work. But a few “innovative” Medigap plans may cover extra benefits such as dental care at no extra cost. The most likely candidate is Medigap Plan G, according to an analysis from the Commonwealth Fund. You can search for Medigap plans in your area with Medicare’s Medigap finder tool.
What is the best Medicare coverage plan?
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 …
Will Medicare pay for dental work?
Original Medicare covers a wide range of medical services and procedures. But routine dental care isn’t one of them.
Does Medigap insurance cover dental care?
Rarely. Medicare supplement plans — also known as Medigap plans — are private policies that Medicare beneficiaries can buy to cover out-of-pocket expenses from Medicare Parts A and B. There are 10 nationally standardized Medigap plans. Their job is to cover any deductibles, copayments, and coinsurance you may incur when using original Medicare.
Do Medicare Advantage policies cover dental care?
Yes. Many Medicare Advantage plans cover dental work, which is one reason they have grown in popularity over the years. Also known as Medicare Part C, Medicare Advantage plans are private policies that bundle Parts A and B together and can provide extra coverage such as dental work, vision care, and hearing aids.
Does Medicaid cover dental care?
It can, but coverage varies state to state. It’s possible to have Medicare and Medicaid at the same time. If you’re one of the 12 million Americans eligible for both programs, known as being dually eligible, Medicare is typically the insurer that pays first, and Medicaid acts as a secondary payer.
The bottom line
Traditional Medicare and most Medigap plans don’t cover dental care, but many Medicare Advantage (MA) plans do. You’ll still need to check which preventive care and advanced treatment benefits your MA plan covers — and how extensive the coverage is.
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.
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Interested in learning more about Medicare, Medigap, and Medicare Advantage plans? WebMD Connect to Care Advisors may be able to help.
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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.
Does Medicare cover dental services?
If you’re wondering whether Medicare offers dental coverage, the answer is, “It depends.” Dental coverage is limited under Original Medicare, and you won’t be covered for most routine dental services. However, routine dental coverage may be available as part of a Medicare Advantage plan.
Original Medicare dental coverage
Original Medicare, Part A and B, does not cover routine dental care, including:
Medicare dental coverage under Medicare Advantage (Medicare Part C)
If you’d like to get more comprehensive dental coverage under Medicare, you might want to consider a Medicare Advantage plan, available under the Medicare Part C program.
Medicare dental coverage under the PACE program
PACE (Program of All-Inclusive Care for the Elderly) is a joint Medicare and Medicaid program that provides health-care services for people living in a community so that they can delay institutional or nursing home-care for as long as possible.
Other dental coverage options
Outside of getting Medicare dental benefits through a Medicare Advantage plan or a PACE program, you may find yourself having to pay the full cost for most routine dental care if you’re enrolled in Original Medicare or in a Medicare Advantage plan that doesn’t include dental coverage.
Learn more about Medicare dental coverage
If you’re interested in Medicare dental coverage, I can find Medicare Advantage plan options that may offer routine dental benefits. To learn more about me, see my photo below and click the “View profile” link read more about my background.
Does Medicare cover dental care?
Yes and no. Original Medicare doesn’t cover most dental care. If you’re shopping for coverage for routine dental care, such as teeth cleaning and X-rays, and other dental care for fillings, extractions, dentures, and more, then Original Medicare doesn’t cover those things.
What type of Medicare covers dental?
Medicare Advantage Plans, sometimes called Part C, combine Original Medicare Part A and Part B into one complete plan. These plans are offered through private insurance companies approved by the government Medicare program. These plans may also offer extra programs and services not covered by Original Medicare, such as dental coverage.
Does Original Medicare, Part A and Part B, cover dental?
Original Medicare is composed of Part A, which is hospital insurance, and Part B, medical insurance. The only instance in which Original Medicare might cover any dental work, is if you suffered a traumatic injury that also affected your jaw, teeth, or mouth and had to be hospitalized. Then, Original Medicare may cover some of that dental care.
What dental services are covered by Medicare?
When it comes to Medicare and dental coverage, only Medicare Advantage Plans (Part C) may offer dental coverage and not all of them do. This coverage is typically basic and could include:
Dental coverage under Medicare: Comparison table
In summary, here are the types of Medicare, what they cover, and if dental coverage is available:
Does Medicare Cover Dental Care?
Dental care is not seen as medically necessary by Medicare. Original Medicare generally doesn’t cover dental exams, procedures or supplies. Part A, however, may help with certain dental services while you’re in the hospital.
Does Medicare Cover Vision Care?
Vision care is not seen as medically necessary, so Original Medicare doesn’t cover eye exams, eyeglasses or other related vision services.
Do Medicare Advantage Plans Cover Dental and Vision?
Medicare Advantage (Part C) plans can offer coverage for dental and vision health items in addition to also offering the same coverage as Original Medicare. Most also include prescription drug coverage as well as other benefits such as hearing health coverage and gym memberships.
Shop Medicare Advantage Plans
Learn more about Medicare Advantage plans and shop plans in your area.
Find Plans in Your Area
You can search and compare available Medicare plans with dental and vision coverage in your area using this simple tool. Just enter your ZIP code, and the tool will generate a list of plans offered where you live.
Medicare Made Clear
Medicare Made Clear is brought to you by UnitedHealthcare to help make understanding Medicare easier. Click here to take advantage of more helpful tools and resources from Medicare Made Clear including downloadable worksheets and guides.
Medicare Made Clear
Whether you're just starting out with Medicare, need to brush up on the facts, or are helping a loved one, start your journey here.
How much does dental insurance cost?
Most standalone dental plans work the same way. They’ll have a monthly premium (usually between $25 and $50 per month) along with an annual deductible (usually between $50 and $100 per year).
What dental insurance is under $1 a day?
For well under $1 a day, you can enjoy a high level of coverage. Popular brands include Delta Dental, Humana, and AARP. Medicaid and Clinics: Local programs are a vital part of Medicare dental coverage.
What is hospitalization dental?
Your hospitalization is the result of a dental procedure.
What happens to your dental insurance after you meet your deductible?
After you meet your deductible, your plan should pay a percentage of costs towards minor and major services – such as fillings, crowns, and periodontal work. Your age or health status should not be much of an issue when getting dental coverage. However, premiums for these plans typically increase with age.
How much does it cost to get a denture?
And costs can add up, especially for major work. Out-of-pocket costs for dentures and dental implants, for instance, can be anywhere from $300 per tooth to $1,500 or significantly more for a full set of dentures.
Do you have to pay for dental care on Medicare?
Medicare Advantage Dental Rules: When you see the dentist on Medicare Advantage, you may have to pay some costs on your own. There will probably be additional rules, like a maximum number of visits or poor coverage for costly procedures.
Does Medicare pay for dental visits?
Most of the time, Medicare won’t pay for your dentist visit. Medicare isn’t alone in its dental gap. Most health insurance plans don’t include dental care, despite efforts from lawmakers. Fortunately, some people with Medicare have found their own solution.
What are the different types of dental plans?
Dental plan categories: High and low. There are 2 categories of Marketplace dental plans: High and low. The high coverage level has higher premiums but lower copayments and deductibles. So you'll pay more every month, but less when you use dental services. The low coverage level has lower premiums but higher copayments and deductibles.
What do you find when you compare dental plans?
When you compare dental plans in the Marketplace, you’ll find details about each plan’s costs, copayments, deductibles, and services covered.
Can you buy a dental plan on the marketplace?
IMPORTANT: You can’t buy a Marketplace dental plan unless you’re buying a health plan at the same time.
Can you change your dental insurance?
If you qualify, you can choose a new health plan with or without dental coverage. But you can’t get dental coverage by itself.
Is dental insurance required for children?
No. Dental coverage is optional, even for children. So you don't need it to avoid the penalty for being uncovered.
Do you have to buy dental insurance for children?
Note: While dental coverage for children must be available to you, you don’t have to buy it. Dental coverage isn't an essential health benefit for adults. Insurers don’t have to offer adult dental coverage.
Is dental insurance included in the marketplace?
Dental coverage is included in some Marketplace health plans. You can see which plans include dental coverage when you compare them. If a health plan includes dental, the premium covers both health and dental coverage. Separate, stand-alone dental plans. In some cases separate, stand-alone plans are offered.