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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
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.
Original Medicare health insurance doesn’t typically cover routine dental services.
These dental care services include:
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.
Many government-approved private insurance companies offer Medicare with dental coverage.
They’re available through these types of dental plans:
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:
Dental services must be an essential part of a covered procedure, such as:
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:
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.
To get dental coverage with Medicare, you can follow two simple steps:
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 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 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 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.
If you are on a Medicare plan that works for you and does not cover dental coverage, you may consider several other options.
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.
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.
Your state health department may have information on where you can receive affordable dental services.
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.
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.
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.
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.
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