The main types of Medicare Advantage plans that cover dental work are HMOs, PPOs In health insurance in the United States, a preferred provider organization, sometimes referred to as a participating provider organization or preferred provider option, is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at reduced rates to the top insur…Preferred provider organization
Full Answer
Which Medicare Advantage plans cover dentures?
While CareSalute is an option for all Medicare beneficiaries, the new plan, offered in Broward and Palm Beach counties, is designed to complement VA healthcare coverage and includes dental coverage, transportation, and a fitness program
Does Medicare Part an or B cover 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. Medicare Part A is designated as hospital insurance.
Should Medicare for all include dental coverage?
The current version of Medicare that covers seniors 65 and older does not include coverage for routine dental care. However the new versions of a Medicare for All program envision a much more robust set of benefits and services including dental care.
Does Medicare have a dental plan?
Yes, Medicare has dental plan options for seniors. For example, you could apply for a Medicare Advantage plan. Many Medicare Advantage plans include vision, dental, and prescription drug coverage. What does my Cigna Dental Plan cover?
What Medicare Dental Coverage Is Available Under Original Medicare?
Original Medicare (Part A and Part B) offers no coverage for routine dental care services. Under Original Medicare, your Medicare dental coverage i...
Do Wellcare Medicare Advantage Plans Offer Medicare Dental Coverage?
Depending on where you live and the plan you select, you may be eligible for Medicare health plans that cover routine and preventive dental care. S...
What Else Do I Need to Know About Wellcare Medicare Advantage Plans With Medicare Dental Coverage?
1. Not all WellCare MedicareAdvantage plans are available in all areas, and additional benefit options, such as routine dental care, may not be ava...
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.
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.
What is Medicare Advantage?
But you might have an alternative. The Medicare Part C program (Medicare Advantage) gives you another way to get your Medicare Part A and Part B coverage. Medicare Advantage plans include the same benefits as Original Medicare (besides hospice care, which Part A continues to cover), and often include additional benefits – such as routine dental ...
What are the benefits of Wellcare?
Depending on where you live and the plan you select, you may be eligible for Medicare health plans that cover routine and preventive dental care. Some WellCare Medicare Advantage plans may offer the following dental benefits: 1 Preventive services such as annual exams, routine cleaning and polishing, and x-rays, at no cost to you if you get them from providers in the WellCare Medicareprovider network. 2 Under some WellCare Medicare plans, covered services you get from dentists in the WellCare Medicareprovider network may be available with no deductible and no copayment (subject to your plan’s annual maximum benefit limit). 3 Minimal paperwork to complete when you use network providers.
Does Wellcare have a deductible?
Under some WellCare Medicare plans, covered services you get from dentists in the WellCare Medicareprovider network may be available with no deductible and no copayment (subject to your plan’s annual maximum benefit limit). Minimal paperwork to complete when you use network providers.
Does Wellcare offer dental insurance?
Some WellCare Medicare Advantage plans may offer the following dental benefits: Preventive services such as annual exams, routine cleaning and polishing, and x-rays, at no cost to you if you get them from providers in the WellCare Medicareprovider network. Under some WellCare Medicare plans, covered services you get from dentists in ...
Does Medicare cover dental care?
Original Medicare (Part A and Part B) offers no coverage for routine dental care services. Under Original Medicare, your Medicare dental coverage is limited to certain medically necessary dental services and treatment for serious injuries, diseases, and conditions that affect the teeth, jaw, and gums. For example, if you fall and break your jaw, ...
Do you have to pay for dental insurance?
You may be required to pay the full cost of your dental care for non-covered services or for services provided by out-of-network providers. Be sure to read your plan documents carefully before you enroll to make sure you understand your coverage and are choosing the dental coverage benefits that are important to you.
Do you have to have copays for Wellcare?
Depending on the plan you choose, you may have copayments, coinsurance amounts, and/or deductibles, and you may need to get care from WellCare Medicarenetwork providers in order for your benefits to apply, or to keep your out-of-pocket costs lower. Some plans have annual limits on routine dental care services.
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:
What is 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.
What is Medicare Advantage?
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. Medicare Advantage plans are offered by private insurance companies.
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 macular degeneration?
However, Medicare Part B may cover some things for vision including preventive or diagnostic eye exams, including glaucoma tests, yearly eye exams to test for diabetic retinopathy and eye tests for macular degeneration, cataract surgery and prescription lenses or eyeglasses in certain situations. But fear not, you have options if you have Medicare ...
Why do seniors need dental care?
As a result, seniors and other Medicare insurance recipients are encouraged to seek out regular dental care as a means of preventing disease and promoting overall health and wellness.
Can dental care be included in rehabilitation?
An exception may be made in cases where dental care is considered a vital part of the rehabilitation treatment being received , but this type of care will not usually be included without paperwork and approval from your plan provider.
Can you predict dental care needs?
With age, it may be easier to predict the need for future dental care needs based on your dental history, allowing you to plan ahead to have affordable coverage in place before care becomes necessary.
Does Medicare Advantage include dental insurance?
Medicare Advantage plans are required to include the same benefits as Part A and Part B , but many include additional coverage, including dental services.
Does Medicare cover dental insurance?
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
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.
