How Do I Get Dental Coverage With Medicare?
Medicare will cover certain aspects of dental care, in some cases, but without extra dental coverage you’ll be missing out on a lot. Original Medicare won’t really help you out with dental care in the way you’re probably thinking of dental care, which is where Part C comes into play.
It’s very rare for someone to go through the entire process of how to apply for Medicare without coming up with a number of different questions. Here’s what you need to know about getting dental coverage with Medicare.
Does Original Medicare cover dental?
Unfortunately, Original Medicare doesn’t cover most dental procedures including cleanings, fillings, dental devices (like dentures), and routine check-ups.
Medicare Part A (hospital insurance) will cover complicated or emergency dental procedures requiring hospital care if they are necessary for treating another medical issue. For example, if you require a tooth extraction before receiving radiation treatment, Medicare will cover the cost of the procedure. Once the primary condition has been treated, Medicare will not cover any follow-up dental treatments.
Where can I find Medicare dental plans?
If you require dental coverage, you can opt for a Medicare Advantage (Part C) plan. Medicare Advantage offers the same coverage as Original Medicare Part A and B with additional benefits like a prescription drug plan, and vision and dental coverage.
To find a Medicare Advantage plan, you will need to enroll through a private insurance company. Plans and prices may vary between carriers, so if you want the best deal you may need to shop around first.
Medicare Advantage is not the same as Medicare Supplement Insurance (Medigap). Medigap helps cover out-of-pocket costs like co-payments and deductibles and doesn’t offer additional benefits like vision or dental coverage.
What dental services will Medicare Advantage cover?
Dental coverage varies between Medicare Advantage plans, but most will cover basic preventive services like routine check-ups, cleanings, X-rays, and fillings. Major dental services like crowns, oral surgery, and extractions are usually covered by Medicare Advantage as well.
When choosing a Medicare Advantage plan, it’s important to verify what services are covered so you don’t end up with a surprise expense on your next dental bill. Medicare Advantage is available through most private insurance companies and may be able to compare plans online.
Other dental coverage options for seniors
If a Medicare Advantage plan isn’t the right choice for you, there are options to choose from including standalone dental insurance and dental discount plans.
If you or your spouse are employed, you might have dental coverage through a group insurance plan. Otherwise, you can purchase standalone dental insurance from a private insurance company.
You can choose between a Preferred Provider Organization (PPO), Health Maintenance Organization (HMO), or Exclusive Provider Organization (EPO). The price of your plan will depend on the amount of coverage and whether you choose a PPO, HMO, or EPO.
PPOs are recommended because you have more choice when it comes to selecting a dental provider whereas HMOs are more restrictive. However, PPOs are usually more expensive, so an HMO might be a better choice if you are on a tighter budget. EPOs are less restrictive than HMOs, but they aren’t as common compared to the other two options.
Dental Discount Plan
Some dental organizations offer dental discount plans (or cards). While they aren’t the same as Medicare or dental insurance, these plans do provide discounts on most dental services, which might make it worthwhile to just put some cash away each month and to find the best prices on dental services in your area.
You will be responsible for paying the bill for any dental services received but the cost will be significantly reduced by using a dental discount plan (as long as your dentist falls within the plan’s network).
Dental discount plans require you to pay an annual fee and can only be used at specific dental clinics. If you already have a dentist, it’s recommended that you ask them if they accept dental discount plans before your next appointment. If so, you could end up staying with the same dentist and saving yourself some money. They may be able to offer you an additional discount for paying your dental bill on the spot.