Medicare Blog

what does medicare pay for dental

by Courtney Ullrich Published 2 years ago Updated 1 year ago
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Do any dentists accept Medicare?

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 …

What dental services are covered by Medicare?

Aug 10, 2021 · Does Medicare Cover Dental Care? Original Medicare does not cover routine dental care. Medicare Part Aand Part B will only cover dental services if they are required for another medical procedure and a physician deems them medically necessary. Additionally, Medicare Part A and Part Bmay cover dental work as a part of or related to an emergency.

Is Medicare insurance accepted by all dentists?

Jan 06, 2022 · According to Medicare.gov, this federal health insurance program typically does not cover dental care, procedures, or supplies. Medicare doesn’t provide benefits toward regular cleanings or services designed to treat and/or correct problematic oral issues, such as fillings or tooth extractions.

Does Medicare cover dental expenses?

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Does Medicare Cover Dental?

Medicare does not cover dental care except in certain specific circumstances. A good rule of thumb is this: if your dental expense is related only...

Does Medicare Cover Dentures?

Dentures – a removable set of artificial teeth – can replace some or all of your natural teeth, helping you to look better and chew food more easil...

Does Medicare Pay For Oral Surgery?

Medicare ordinarily does not pay for oral surgery in a dentist or oral surgeon’s office or outpatient facility. However, there are a few exceptions...

Does Medicare Cover Dental exams?

Medicare does not cover routine dental exams. However, it will cover dental exams performed as part of an overall exam before a kidney transplant o...

Does Medicare Cover Dental Cleanings?

Regular dental cleanings are essential to good oral health, and the American Dental Association recommends that you follow your dentist’s recommend...

Does Medicare Cover Invisible Aligners?

Invisible aligners are a less-noticeable alternative to traditional metal braces for straightening teeth. Medicare generally will not pay for eithe...

Does Medicare Cover Wisdom Teeth Removal?

Wisdom teeth are typically removed by an oral surgeon in an in-office procedure. These routine extractions are considered dental procedures that ar...

Does Medicare Supplemental Insurance Cover Dental?

Medicare Supplement, or Medigap, insurance, can take care of many healthcare costs that are not paid by Original Medicare Parts A and B, including...

How Do I Get Dental Coverage For Seniors?

There are two ways for Medicare enrollees to get dental coverage. The first is to enroll in a Medicare Advantage plan that offers dental benefits....

How much does a dental plan cost?

A good dental plan can help you stay on top of cleanings and make it easier to afford major procedures. Dental plans can cost as little as $9 and range to $63+ per month.

What is Humana dental insurance?

Humana is one of the most popular carriers for senior dental insurance. Also, an indemnity solution we offer costs about $1 a day and there are no networks for dentists, audiologists, or optometrists. To learn about the details, give us a call at the number above. We can help you find the policy that's best for you.

Who is Lindsay Malzone?

Lindsay Malzone is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

Does Medicare cover tooth extractions?

Does Medicare cover tooth extraction? Medicare covers tooth extractions to prepare you for radiation treatment for jaw cancer. Otherwise, it won’t pay for a tooth extraction. If you have a dental policy or an Advantage plan covering dental, your plan may cover extractions.

What is an abscess in a tooth?

An abscess is an infection in your gum or at the root of a tooth. If you develop an abscess, your dentist may perform a root canal treatment or pull the tooth. The dentist may also prescribe antibiotics. Many dental policies cover root canal treatments, but you’ll have to pay part of the cost.

Does insurance cover orthodontics?

But, some insurance companies usually treat aligners the same as braces. If your dental insurance includes orthodontic work, it will typically cover aligners. With that said, it may be hard to find insurance that includes adult orthodontic coverage. If you do, you can expect to pay a percentage of the cost.

Does dental insurance cover dental procedures?

Coverage can vary. Some plans cover only standard services, and others cover a wide range of dental procedures. Research plans, so you understand what’s included before signing up. Advantage plans often include vision and hearing benefits as well.

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Statutory Dental Exclusion

  • Section 1862 (a)(12) of the Social Security Act states, "where such expenses are for services in connection with the care, treatment, filling, removal, or replacement of teeth or structures directly supporting teeth, except that payment may be made under part A in the case of inpatient hospital services in connection with the provision of such dent...
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Background

  • The dental exclusion was included as part of the initial Medicare program. In establishing the dental exclusion, Congress did not limit the exclusion to routine dental services, as it did for routine physical checkups or routine foot care, but instead it included a blanket exclusion of dental services. The Congress has not amended the dental exclusion since 1980 when it made a…
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Coverage Principle

  • Coverage is not determined by the value or the necessity of the dental care but by the type of service provided and the anatomical structure on which the procedure is performed.
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Services Excluded Under Part B

  • The following two categories of services are excluded from coverage: A primary service (regardless of cause or complexity) provided for the care, treatment, removal, or replacement of teeth or structures directly supporting teeth, e.g., preparation of the mouth for dentures, removal of diseased teeth in an infected jaw. A secondary service that is related to the teeth or structure…
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Exceptions to Services Excluded

  • The extraction of teeth to prepare the jaw for radiation treatment of neoplastic disease. An oral or dental examination performed on an inpatient basis as part of comprehensive workup prior to renal transplant surgery or performed in a RHC/FQHC prior to a heart valve replacement.
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Definition

  • Structures directly supporting the teeth means the periodontium, which includes the gingivae, periodontal membrane, cementum of the teeth, and the alveolar bone (i.e. alveolar process and tooth sockets).
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