Is There Dental Coverage Under Medicare?
Oral health is an important part of living a healthy life, especially as we age. In fact, the Centers for Disease Control (CDC) reports that for adults ages 65+:
- 96% have had a cavity, and 20% have untreated tooth decay.
- 68% have gum disease.
- Almost 20% have lost all of their teeth.
- Tooth loss becomes twice as prevalent among those 75 and older.
- The median age of oral cancer diagnosis is 62 years.
- Many medications for older adults reduce saliva production, thereby increasing the risk of cavities.
Unfortunately, if your only coverage is Medicare, you might have to go without dental insurance, including coverage for things like routine care, fillings, extractions, and dentures.
The good news is that in this article, I’ll outline what you can do to receive quality dental as a senior insured under Medicare.
Which Dental Services Does Original Medicare Cover?
Medicare doesn’t cover standard dental procedures like cleanings, fillings, extractions, dentures, and dental plates, or their related supplies. However, if you’re hospitalized and receive inpatient care, Medicare Part A might cover dental-related emergencies or procedures that are integral to other medical treatments.
With this said, some plans might cover a maximum of $1,000 to $2,000, and then you’re responsible for 100% of the remaining dental charges.
What about Part C plans?
Do Advantage Plans Cover Dental Work?
Since each Medicare Advantage plan is different, some offer additional coverage for dental work, as well as other aspects like vision and hearing. In fact, According to the Kaiser Family Foundation, in 2020, 88% of Medicare Advantage plans provided at least some dental coverage.
Keep in mind, though, that while coverage under these plans is broader than Medicare, it’s still generally limited to common procedures like teeth cleaning, routine x-rays, extractions, and fillings.
Therefore, if dental is vital to you, make sure you only consider plans with the coverage, dental or otherwise, you need most.
You can also purchase a stand-alone dental plan from other carriers, many of which are designed specifically for seniors’ needs. Furthermore, if you’re on a limited income, Medicaid provides some benefits, although they can vary significantly from state to state.
Here’s a quick table outlining what we’ve discussed so far:
|Medicare Type||Provide Dental Coverage?|
|Original Medicare||No, except for injuries that require hospitalization and which are related to other necessary medical treatments.|
|Medicare Advantage (Part C) Plans||Yes, although coverage can be limited depending on the plan you choose. This is why it’s ultra-important that you understand the coverages you’re getting before signing on the dotted line.|
|Medicare Supplement (i.e., Medigap) Insurance||No|
What Options are Available for Seniors with No Dental Coverage?
A number of third-party programs exist to help seniors with limited or no dental care. Here is a handful:
- PACE (Program of All-Inclusive Care for the Elderly)
- Federally Qualified Health Centers (FQHC)
- Dental Life Network
- Dentistry From the Heart
If you have a dental school near you, they often offer low-cost or free dental work. If so, it could be worth giving them a call and checking out their program.
Before you turn 65, you can also contribute to a Health Savings Account (HSA), which stops as soon as you enroll in Medicare. Still, the money you saved in the interim can be used for non-covered dental exams and procedures.
Do You Have Additional Questions About Medicare Dental Care?
Perhaps more than any other population segment, proper dental care and good oral health are essential for leading a happy, healthy life. That’s why the professionals at IHS Insurance Group have the knowledge and experience you need to find the coverage that’s right for you and at a price that won’t break the bank.
Need a FREE Quote or have questions regarding Medicare Coverage? We have three convenient ways to reach us:
- If you prefer to talk to a licensed agent directly, please call (866) 480 5063.
- If you prefer to fill out a quick form and have an agent get back to you at your convenience, use the GET A FREE QUOTE.
- Lastly, for those that want an immediate quote, please click HERE.
Also, check out our Medicare FAQs here.