Taking care of your teeth is an important part of your health and having dental coverage is essential for many. Big procedures, such as dentures, dental implants and oral surgery can get expensive quickly, which is why knowing your coverage options under Medicare is crucial.
Original Medicare doesn’t cover everything, especially when it comes to dental care. Knowing what is and isn’t covered can help you make Medicare decisions going forward.
Original Medicare Dental Coverage
What coverage can you expect from Medicare regarding dental care? Medicare Parts A and B will cover necessary in-patient dental services, such as a dental emergency when you are in the hospital. However, Original Medicare (Parts A and B) does not offer coverage for most dental care.
Original Medicare does NOT cover:
- Routine exams
- Tooth extractions
- Dental Implants
Medicare Advantage Dental Coverage
The lack of dental coverage with Medicare may be disappointing, especially when you’re in need of dental work. While Original Medicare doesn’t cover these services, Medicare Advantage offers many additional benefits that may provide the dental coverage you need.
Medicare Advantage, sometimes referred to as “Part C” plans, are offered through private insurance companies. Medicare Advantage plans cover all of the services that Original Medicare (Parts A and B) offers, and often include additional benefits such as dental, vision and hearing. Medicare Advantage also typically bundles prescription drug coverage in the same plan.
Each plan is different, so it’s important to read the full summary of benefits to understand the level of dental coverage offered. Some MA plans fully cover preventative dental care such as an annual dental exam and cleaning, with or without a copay for the visit. Other plans may offer partial coinsurance for a range of dental care. Some plans specify covered dental procedures while others are more comprehensive, and some will have max annual dental benefit limits and others will be unlimited. If you need dental implants or dentures, be sure you find out the level of dental coverage available for the Medicare Advantage plans in your area.
Frequently Asked Questions
Just like all non-covered dental services with Original Medicare, you will be responsible for 100% of the cost out-of-pocket. However, many Part C Medicare Advantage plans offer varying amounts of dental benefits to cover some or all of the costs for dental implants.
Just like all non-covered dental services with Original Medicare, you will be responsible for 100% of the cost out-of-pocket. However, many Part C Medicare Advantage plans offer varying amounts of dental benefits to cover some or all of the costs for dentures.
Some Medicare Advantage plans offer coverage for dentures, dental implants and oral surgery, though coverage varies based on the plan.
Some Medicare Advantage plans offer coverage for dental implants, dentures and oral surgery, though coverage varies based on the plan.
Annual Enrollment Period (AEP)
Medicare Annual Enrollment Period runs each year from October 15 to December 7. What is the Annual Enrollment Period vs. Open Enrollment Period?
Initial Enrollment Period (IEP)
Your Initial Enrollment Period generally surrounds your 65th birthday but may occur if you otherwise become eligible for Medicare for the first time.
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