There are many different aspects when it comes to covering all medical needs. Most seniors need to have coverage for inpatient hospital stays, outpatient doctor visits, and prescription medication. Thankfully, Medicare Part A, Medicare Part B, and Medicare Part D take care of all of these needs. However, the coverage of dental services remains a question.
Unfortunately, Medicare does not cover dental services. There are some exceptions to this rule. There are also many other ways for each senior to get the dental coverage they need.
Does Medicare Cover Dental Services?
Medicare does not cover routine dental services for seniors. The services not covered include exams, cleanings, crowns, fillings, bridges, or any other procedure done at the dentist’s office. While Medicare does not cover these essential, routine services, Medicare will typically cover emergency dental work.
For example, if you have an accident that breaks your jaw, Medicare might help cover the jaw reconstruction surgery. This is also true for other scenarios, such as doctor-ordered tooth extractions. A tooth may be causing infection or other significant health impacts.
Medicare will also cover any dental exams that a doctor orders before any major surgery. This ensures that you stay entirely safe during all procedures. Also, you don’t have to pay any extra costs for these dental checks.
If you, however, want routine cleanings, fillings, crowns, or other dental services, you must get an additional dental plan. Before you decide to add on one of these plans, you can consider your other options.
Dental Coverage Under Medicare PACE
If eligible, many seniors might be able to get some dental coverage under the Medicare PACE program. You must be dual-eligible to qualify for this program, meaning you must be eligible for both Medicare and Medicaid. If this is the case, among many of the program’s benefits, dental care is included in its list of covered services.
Enrolling in the Medicare PACE program to get dental benefits is smart for many reasons. Not only would you receive covered dental services, but you would also receive all of the other benefits included in the program, such as adult day care, physical therapy, and more. If you qualify, this will prove to be one of the most economical options to get dental coverage.
Dental Coverage Under Medicare Advantage
Enrolling in a Medicare Advantage (Medicare Part C) plan might be another option for a senior looking for ways to cover their dental services. Unlike Original Medicare Parts A and B, Medicare Advantage is a private insurance plan that offers the same benefits, and some additional benefits as Original Medicare. The dental services covered within Medicare Advantage may include routine cleanings, exams, X-rays, and fillings. While this may seem enticing, it’s important to remember that most Medicare Advantage plans require you to see a provider within the plan’s network. This limits the number of providers you can see for your services, meaning you might not get to go to your preferred provider.
Not all Medicare Advantage plans offer dental benefits, and some offer more services than others. When considering this plan, it’s important to find a plan that has the dental benefits you currently need and will need in the future, as well as determine which plan fits your monthly budget.
Dental Coverage for Seniors
Instead of filling yourself with uncertainty by searching for a Medicare Advantage plan with dental benefits, we recommend that most seniors keep their Original Medicare. After deciding to keep Original Medicare, it is essential to add a Medicare Supplement plan to fill all the gaps in coverage, and then, add a dental plan.
Adding a separate dental plan in addition to a Medicare Supplement plan ensures that you will get all of the medical services that you need. Depending on the plan you choose, you may not have to pay any money out-of-pocket. This tends to be the most attractive options for seniors. It would save the most money in the long run.
At GoMedigap, we bundle our dental plans with vision and hearing plans for a low cost. This means you will get dental, vision, and hearing coverage for a small price each month.
Nothing on this website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.