What Does Medicare Dental Cover?

Many Americans don’t visit the dentist for checkups as often as they’d like or should. This is because of the toll it can take on their wallets. However, skipping routine dental care can lead to more expensive and painful procedures later.

Medicare is a federal health insurance program for seniors and people with disabilities. 

It’s generally available for the following:²

• Anyone who is 65 or older
• Under 65 with certain disabilities
• People with End-Stage Renal Disease
• People with ALS (also called Lou Gehrig’s disease) 

Medicare covers some types of medical care, but does it also cover dental services? Let’s look at dental coverage under Medicare in this article.

Does Medicare Cover Dental Care?

Original Medicare health insurance doesn’t typically cover routine dental services. 

These dental care services include: 

• Cleanings
• Fillings
• Tooth extractions
• X-rays
• Dentures
• Dental plates

On the other hand, nearly all Medicare Advantage health plans offer dental coverage. However, coverage is limited and varies widely, which can result in high out-of-pocket costs.

What Dental Services Are Covered By Medicare?

Many government-approved private insurance companies offer Medicare with dental coverage. 

They’re available through these types of dental plans:

Original Medicare 

Original Medicare has two parts: Part A (hospital insurance) and Part B (medical insurance). 

Part A of the Original Medicare plan covers certain dental services you may need while you’re in a hospital.⁵ This includes any emergency or complicated dental procedures you may need while in inpatient care.⁸

For example, in:

• An acute care hospital
• A critical access hospital
• An inpatient rehab facility
• A long-term care hospital
• Mental health care
• Inpatient care as part of a research study

Dental services must be an essential part of a covered procedure, such as:

• Jaw reconstruction surgery following an injury
• Tooth extractions to prepare for radiation treatment for conditions causing tumors that involve the jaw
• Oral examinations (but not treatment) before kidney transplants or heart valve replacements

Medicare Advantage Plans (Medicare Part C)

Medicare Advantage plans combine Medicare Part A and Part B into one comprehensive plan. Private companies approved by Medicare offer this type of plan.¹

A Medicare Advantage plan may also provide additional benefits, such as: 

• Dental coverage
• Vision benefits
• Prescription drug benefits 

If you have a Medicare Advantage plan that includes dental coverage, you may be able to get free or low-cost dental care. 

However, not all Medicare Advantage plans include Medicare dental coverage. It’s important to check each plan’s details before enrolling. Confirm what dental services are included in your plan’s coverage since dental benefits vary.

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. 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. It’s wise to compare your coverage options.

Best Medicare Dental Plans (Coverage Options)

You must decide which dental insurance plan makes the most sense for your oral healthcare needs and budget.

Here are some top Medicare dental providers:

Humana 

Humana boasts the most Medicare Advantage enrollees. It offers 83 plans in most counties across the country. Eighty-five percent of Medicare beneficiaries have access to at least one Humana plan.

UnitedHealthcare 

UnitedHealthcare is up there with Humana with the most Medicare Advantage enrollees. It offers plans in 60 percent of counties across the country. Eighty-two percent of Medicare beneficiaries have access to at least one UnitedHealthcare plan.

Anthem 

Anthem provides all kinds of plans. These plans include 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 comes with preventive care benefits.

How to Receive Dental Coverage if Medicare Doesn’t Include It

If you are on a Medicare plan that works for you and does not cover dental coverage, you may consider several other options.

Purchase a Separate or Standalone Dental Plan

You can choose a separate or standalone dental plan from a private insurance company. There are various types of dental plans to select from. They typically come with affordable monthly premiums.

Look for an Affordable Walk-in Dental Clinic

Depending on where you live and what type of dental services you require, you may be able to find affordable treatment. This is even if it involves paying out-of-pocket.

Check with your State Department of Health

Your state health department may have information on where you can receive affordable dental services.

Visit a Local Dental School

If you have a dental school or university program nearby, you can contact them to see if they provide free or low-cost dental services.

Open a Health Savings Account (HSA)

Before 65, you can consider opening a HSA if you have a high deductible health plan. Once you enroll in Medicare, you can no longer add to the fund. However, you can use what you have saved for covered expenses like eligible dental care.

Why Should Seniors Get Medicare?

Medicare plans help seniors save money. Many seniors are adversely affected by oral healthcare bills. 

For instance, about 20% of seniors have untreated dental cavities. Nearly 1 in 5 have lost all of their natural teeth.¹¹ However, elderly Americans report high dental care costs are a major barrier to routine dental services. 

Qualifying for Medicare can help you access dental care without breaking the bank.

Summary

Medicare can be a great resource for seniors who need help accessing affordable healthcare. While most Medicare plans don't provide dental coverage, there are ways to get the help you need. 

A Medicare Advantage plan may include coverage for basic dental care. Alternatively, you can purchase a separate or standalone dental plan from a private insurance company.