Medicare Blog

what is medicare covered dental

by Lyla Pfeffer MD Published 2 years ago Updated 1 year ago
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Medicare Part A will cover some dental procedures that happen in a hospital stay. For instance, if you’re in a car wreck that damages your jaw and you go to the hospital, Medicare would cover any reconstruction of your jaw. Medicare may also cover the following types of things:

Full Answer

How does Medicare actually cover dental treatment?

Medicare doesn't cover most dental care, dental procedures, or 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 inpatient hospital care if you need to have emergency or complicated dental …

Do any dentists accept Medicare?

Apr 04, 2019 · Original Medicare dental coverage. Original Medicare, Part A and B, does not cover routine dental care, including: Cleanings and oral exams; Fillings; Crowns; Bridges; Dental appliances, including dentures or dental plates; There are a few exceptions to this. Medicare Part A may cover certain dental services performed in a hospital if it’s a necessary part of a covered …

How do I get dental coverage with Medicare?

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.

Should Medicare for all include dental coverage?

Nov 22, 2021 · 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. Medicare Part A is designated as hospital insurance.

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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 y...

Original Medicare Dental Coverage

Original Medicare, Part A and B, does not cover routine dental care, including: 1. Cleanings and oral exams 2. Fillings 3. Crowns 4. Bridges 5. Den...

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 M...

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...

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...

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...

What is 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.

What is the age limit for a PACE?

In addition, PACE may include certain benefits beyond the Medicare program, such as dental services. You may be eligible if you’re 55 years or older and enrolled in Medicare, Medicaid, or both programs (also known as a “dual eligible”).

Does Medicare Advantage cover dental?

Offered through Medicare-contracted private insurance companies, these plans are required to offer at least the same coverage as Original Medicare (except for hospice); in other words, a Medicare Advantage plan would cover dental care under the same situations as Original Medicare.

Is dental insurance part of Medicare?

Dental insurance may be another option if you want help with dental costs. Keep in mind that stand-alone dental plans are not part of the Medicare program, and this coverage may come with certain costs, including premiums, deductibles, coinsurance, and copayments.

Does Medicare cover dental care?

Original Medicare, Part A and B , does not cover routine dental care, including: There are a few exceptions to this. Medicare Part A may cover certain dental services performed in a hospital if it’s a necessary part of a covered service.

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

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 ...
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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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