Medicare Dental

Evidence Based
NewMouth is reader supported. We may earn a commission if you purchase something using one of our links.

Medicare Dental Insurance for Seniors (65+)

Oral healthcare is pricy, and it’s only getting pricier. The average per-capita spending on dental care increased by a lofty 81 percent from 1990 to 2016. Today, the average cost of a dental cleaning is about $90 to $120, and that number, of course, goes up depending on your oral healthcare needs. 

Cleaning excessive plaque and tartar can easily tack on another $100, and if you need fillings, tooth extractions, dental implants, or more, you can expect to pay upwards of thousands of dollars by the end of your treatment.

If you’re one of the more than half of Americans who visit the dentist once every six months (or more if you need specific dental work done), you probably don’t want to be paying full price for dental services. 

In fact, the reason so many Americans (59 percent) don’t visit the dentist for checkups as often as they’d like (or should) is because of the toll it can take on their wallets. But dental health is critical, and skipping routine dental care can ultimately lead to more expensive and more painful dental procedures down the line.

Why Should Seniors Get Medicare?

Seniors (65 years old and up) are adversely affected by hefty oral healthcare bills. About 20 percent of seniors have untreated dental cavities, and a quarter are missing all of their natural teeth. But elderly Americans, more than other groups, report that high cost is a major barrier to getting routine dental services.

If you’re a senior, financial assistance is available. You may qualify for certain Medicare dental plans that can save you serious money.

What Dental Services Are Covered By Medicare?

It’s important to note that Original Medicare health insurance doesn’t typically cover more dental care, procedures, or supplies such as cleanings, fillings, tooth extractions, x-rays, dentures, or dental plates. That’s largely why nearly two-thirds of Medicare enrollees don’t have any dental insurance at all—and why one in five haven’t seen a dentist in the last five years.

Nearly all (88 percent) of Medicare Advantage health plans provide at least some dental coverage. Many government-approved, private insurance companies offer Medicare coverage with dental services through these types of dental plans:

  • Original Medicare (Part A) — Original Medicare includes Part A (hospital insurance) and Part B (medical insurance). The Part A portion of the Original Medicare plan will cover certain dental services you may need while you’re in a hospital. This includes any emergency or complicated dental procedures you may need while in inpatient hospital care (in an acute care hospital, critical access hospital, inpatient rehabilitation facility, long-term care hospital, mental health care, or inpatient care as part of a qualifying research study).

The dental services must be an integral part of a covered procedure, such as jaw reconstruction surgery following an injury, tooth extractions to prepare for radiation treatment for neoplastic diseases that involve the jaw, and oral examinations (but not treatment) that precede kidney transplants or heart valve replacements.

  • Medicare Advantage Plans (also known as Medicare Part C) — This insurance plan combines both Medicare Part A and Part B into one comprehensive plan that may also include dental coverage, as well as vision and prescription drug benefits (Part D).

    Not all Part C Plans include medicare dental coverage, however, so it’s important to check each plans’ details before enrolling. It’s also important to confirm exactly what dental services are included in your plan’s coverage, such as dentures or extractions, since benefits may vary.

Medicare supplemental dental insurance also falls under Medicare; however, it does not include dental care.

Who Qualifies For Medicare Dental Coverage?

Medicare is generally available for anyone who is 65 of age or older, as well as some younger people with certain disabilities and those with End Stage Renal Disease (permanent kidney failure that requires dialysis or a kidney transplant).

Almost all Medicare beneficiaries (97 percent) have access to a Medicare Advantage plan that provides dental coverage, among other health services, that traditional Medicare doesn’t cover.

How Do I Get Dental Coverage with Medicare?

To get dental coverage with Medicare, you can follow two simple steps:

  1. Decide what Medicare dental coverage is important to you. Not all plans have the same offerings, so make a list of your musts and the benefits you could do without.
  2. Shop around for affordable Medicare dental insurance that meets your needs. There are tons of providers that offer Medicare dental plans, so it’s wise to compare your coverage options.

Best Medicare Dental Plans (Coverage Options)

Here are three top Medicare dental providers out there. It’s up to you to decide what specific dental insurance plan makes the most sense for your oral healthcare needs and budget.

  1. Humana — Humana boasts the most Medicare Advantage enrollees, offering 83 plans in most counties across the country. Eighty-five percent of Medicare beneficiaries have access to at least one Humana plan.
  2. UnitedHealthcare — UnitedHealthcare is up there with Humana with the most Medicare Advantage enrollees, offering plans in 60 percent of counties across the country. Eighty-two percent of Medicare beneficiaries have access to at least one UnitedHealthcare plan.
  3. Anthem — Anthem offers all kinds of plans from HMOs that save you money on doctor visits (some with a free monthly premium) to PPOs that allow you to visit both network dentists and doctors outside your network for a fee. Each plan, regardless of which one you choose, comes with preventive care benefits.

Resources

(DCD), Digital Communications Division. “What Is Medicare Part C?” HHS.gov, 21 Aug. 2015, www.hhs.gov/answers/medicare-and-medicaid/what-is-medicare-part-c/index.html#:~:text=Medicare%20Advantage%20Plans%2C%20sometimes%20called,private%20companies%20approved%20by%20Medicare.&text=Medicare%20Advantage%20Plans%20may%20offer,drug%20coverage%20(Part%20D)

(DCD), Digital Communications Division. “Who Is Eligible for Medicare?” HHS.gov, 21 Aug. 2015, www.hhs.gov/answers/medicare-and-medicaid/who-is-elibible-for-medicare/index.html

“Average Cost of Teeth Cleaning Without Insurance.” Cigna Discount Dental Plans, 12 Feb. 2019, www.cignadentalplans.com/dental-care/cost-of-teeth-cleaning-dental-insurance

“Buying Prescription Eyeglasses? Your Rights Are Clear.” Consumer Information, 13 Mar. 2018, www.consumer.ftc.gov/blog/2016/05/buying-prescription-eyeglasses-your-rights-are-clear

Carrns, Ann. “Long-in-the-Tooth Dental Advice.” The New York Times, The New York Times, 19 Nov. 2014, www.nytimes.com/2014/11/19/your-money/long-in-the-tooth-dental-advice-.html?_r=0

“Dental Services.” Dental Service Coverage, www.medicare.gov/coverage/dental-services

“Does Medicare Cover Dental?” Cigna, www.cigna.com/individuals-families/understanding-insurance/does-medicare-cover-dental.

“Home.” Humana, www.humana.com/dental-insurance/ways-seniors-medicare-dental-coverage

“Medicare Dental Coverage.” CMS, www.cms.gov/Medicare/Coverage/MedicareDentalCoverage

“Medicare Health Insurance Plans.” UnitedHealthcare, www.uhc.com/medicare

Meredith Freed, Tricia Neuman Follow @tricia_neuman on Twitter, and Mar 2019. “Drilling Down on Dental Coverage and Costs for Medicare Beneficiaries.” KFF, 13 Mar. 2019, www.kff.org/medicare/issue-brief/drilling-down-on-dental-coverage-and-costs-for-medicare-beneficiaries/

“Oral Health for Older Americans.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 22 May 2019, www.cdc.gov/oralhealth/basics/adult-oral-health/adult_older.htm

“Patients.” ADA Health Policy Institute FAQ – Dental Patients in the U.S., www.ada.org/en/science-research/health-policy-institute/dental-statistics/patients

“Please Enable Cookies.” StackPath, www.dentaleconomics.com/articles/print/volume-106/issue-7/macroeconomics/the-dental-economics-annual-fee-survey.html

“Products - Data Briefs - Number 197 - May 2015.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 6 Nov. 2015, www.cdc.gov/nchs/products/databriefs/db197.htm

Shop Medicare Plans, shop.anthem.com/medicare/shop/landing?brand=ABCBS&role=consumer&locale=en_US.

Updated on: August 28, 2020
Author
AnnaMarie Houlis
About
Medically Reviewed: August 27, 2020
Photo of Lara Coseo
Lara Coseo
About
menu