Does Medicare Cover Dentures?

Summary: Dentures for seniors on Medicare is available, but only under certain circumstances. Original Medicare doesn’t ordinarily provide coverage for dental care, but other options are available, primarily through Medicare Advantage plans. Nevertheless, beneficiaries have many options available. Estimated Read Time: 8 mins

If you have Original Medicare, you may find denture coverage. However, Original Medicare does not provide benefits for dentures. Thus, if you have Medicare Part A and Part B and seek coverage for your dentures, you may not have the right coverage for your needs.

Dentures for seniors on Medicare are a vital consideration for millions of beneficiaries, and there are ways to have your devices covered to avoid paying out of pocket. This includes options outside of Medicare coverage which may be the best option for your healthcare needs and budget.

So, does Medicare pay for dentures? Below, we’ll explain how to have Medicare cover dentures, the types of coverage that won’t, the amount you’ll pay without coverage, and additional options that may help you cover the costs of your device.

Are Dentures Covered by Medicare?

Dentures are not covered by Medicare through Original Medicare, as with virtually all dental care. The exception may occur if your physician gives written notice that a procedure or device is deemed medically necessary for your health.

But it’s important to note that coverage for dentures on Medicare can still occur. To better illustrate how this is possible, it’s important to understand how Medicare benefits are provided:

• Original Medicare is Medicare Part A and Part B, and the federal government provides these benefits.
• There are also Medicare Advantage plans, Medicare Supplement (Medigap) plans, and Medicare Part D plans which are benefits provided to beneficiaries through private insurance companies.

There are guidelines that private insurance companies must follow, but there is also the opportunity to provide additional benefits. Therefore, while Original Medicare doesn’t cover dentures, without rare exceptions, other forms of coverage provided by private insurance companies may be at the company’s discretion for each individual plan.

How Much Do Dentures Cost With Medicare?

The cost of dentures with Medicare benefits will vary as the devices can cost from $700 to $1,500+ per denture. This means you could spend $1,500-$3,000+ for a full mouth. Additionally, while you may find dentures for seniors on Medicare, you’ll also note that each plan offers differing levels of coverage.

Medicare may cover dentures through Medicare Advantage plans that offer such benefits, but most dental procedures are not ordinarily covered. If you do have benefits that provide dental, finding full coverage is even harder to find. This means you’ll likely have to pay at least a portion of the cost of your dentures.

For many seniors, even paying half of the cost of dentures can be costly enough, but it’s also important to remember that this is the floor when it comes to pricing. More complex denture procedures involving implants or other necessary healthcare can cost several thousand dollars more. There are extractions and many other costs that may also go into your procedure.

Do Any Medicare Plans Cover Dentures?

While Medicare dentures aren’t always available, there are plans that provide coverage for these devices. Understanding which type of benefits provides you with Medicare denture coverage is critical for getting your healthcare needs. Let’s break down how to get Medicare to help pay for dentures:

Original Medicare (Medicare Part A and Part B)

Medicare will pay for dentures through Part A and Part B but only through very few exceptions. Overwhelmingly, beneficiaries should not expect coverage through Original Medicare and must have a doctor deem their dentures medically necessary before receiving coverage.

The Centers for Medicare & Medicaid Services outlines the Statutory Dental Exclusion in Section 1862 (a)(12) of the Social Security Act, which makes dentures covered by Medicare Part A a possibility for qualifying medical needs.

Medicare Part D

Medicare dentures coverage is not available through Part D benefits. While you can receive plenty of useful benefits for covering your prescription drugs, you won’t find denture coverage.

Medicare Supplement (Medigap)

Even though Medigap plans are provided by private insurance companies, don’t expect to find Medicare dental coverage for dentures here. While there are 12 Medicare Supplement plans available, which include two high deductible versions of plans, they cover the leftover expenses of what Original Medicare doesn’t.

Since Parts A and B don’t offer coverage for dentures on Medicare, there is no need for supplemental coverage and no benefits from Medigap as a result. However, if you want additional benefits to Original Medicare and coverage for your dentures, options are still available through alternative plans.

Does Medicare Advantage Cover Dentures?

There are Medicare Advantage plans that cover dentures. However, these plans are not available in all locations or by all carriers as benefits vary from company to company. Furthermore, your coverage can vary from plan to plan, and plan availability will depend on where you live, making these benefits comparatively rare.

It’s also important to remember that although you can find plans that allow Medicare to pay for dentures, they all come from private insurance companies. Specifically, you’ll virtually be limited to being covered by Medicare Advantage plans.

Having a Medicare Medical Savings Account (MSA) through a Medicare MSA plan may provide funding for dentures, as they are savings specific for healthcare needs. Be aware that these plans can have high deductibles and that dentures won’t count toward them.

You’ll also want to weigh all of your healthcare and budget needs when choosing coverage, which should include your need for dentures but also consider the many other needs you may have. This is because when it comes to Medicare Advantage and Medigap coverage, you can only have one or the other.

Even with a Medicare Advantage plan, you’ll be limited in your coverage according to your plan’s coverage limits. For some, this means full coverage of your dentures, but for others, you may have to pay for some of the cost out of pocket while your Medicare Advantage benefits cover the rest.

Does Medicare Part B Cover Dentures?

Medicare Part B won’t cover dentures as Original Medicare doesn’t provide benefits for dental. Medicare Part B is for covering outpatient procedures, meaning it’ll cover expenses associated with visiting your doctor’s office and similar healthcare needs.

Again, as is the case with Medicare benefits, there may be an exception should your doctor find the procedure medically necessary. But the primary source of this rare occurrence is through Medicare Advantage plans and Medicare Part A, which also requires an exception.

Does Medicare Part C Cover Dentures?

Medicare coverage for dentures is available through Part C benefits because this is the same thing as Medicare Advantage. Both names are related to the same type of benefits, and the same characteristics involving covering your dentures with Medicare apply to each moniker. They are one and the same.

Does Medicare Pay For Denture Relining?

While Original Medicare doesn’t cover dental procedures or devices, you may find coverage for denture relining through Medicare Advantage. But whether or not your benefits cover denture relining will vary from plan to plan.

Each Medicare Advantage plan will offer unique benefits, and it’s essential to understand what your specific coverage provides. For example, even if you have one of the few Medicare Advantage plans offering denture coverage, relining may not be a covered healthcare service.

Therefore, before you enroll in any coverage or receive any medical procedure, you should look into the specifics of your Medicare Advantage plan and understand what is covered. Alternatively, dental coverage may be a better option for some Medicare beneficiaries looking to have their benefits cover denture relining.

Dentures for Seniors on Medicare

Dentures for seniors on Medicare can be necessary regardless of which coverages are available, meaning you’ll need to know how to cover yourself even if your benefits won’t. The good news is that many other options exist for beneficiaries outside of Medicare.

Because the only Medicare benefits that typically provide dental coverage are Medicare Advantage plans, it’s also worth noting dental benefit options outside of Medicare if you are enrolled in a Medigap plan to supplement your coverage.

Medicare dentures aren’t always available. Here are several alternatives that may help you cut costs for your healthcare:

• There are several options of dental insurance for seniors available that can help complement your Medicare coverage.
• While Medicare Supplement plans typically don’t offer dental coverage, some companies may provide you with extra coverage when you enroll.
• Medicaid is available in most states for those that qualify for the program and need dentures. This includes access to Programs of All-Inclusive Care for the Elderly (PACE).
• The Dental Lifeline Network offers state programs to those with lower incomes needing access to dental care. You can also use local community health centers to find healthcare providers that may meet your income needs.
• Discount programs exist that can provide you with discounted rates for dentures from specific healthcare providers. Note you may need to pay an annual fee to gain access to such programs.
• VA dental care benefits are also available to Veterans, but the amount of coverage you’ll receive depends on your disability rating.
• Dental schools can offer procedures at a discounted rate performed by students looking to hone their skills.

How To Have Medicare Cover Dentures

The best way to have Medicare cover dentures for your dental needs is to work with a licensed agent. This is because if you work with a professional, you can take a comprehensive look at all available options and save more in the process.

Medicare Advantage plans are great for many but not for everyone. They come with restrictive networks and may not always be the best option for your healthcare overall. The last thing anyone wants to do is be covered for dentures but spend more in the long run because they don’t have adequate coverage for all their healthcare needs.

Comparing your options, including Medicare Supplement plans and dental coverage, is a great way to ensure that you are covered for your healthcare needs today and in the future while saving the most money in the process.

To have Medicare cover dentures, call us at the number above, or fill out our online rate form to discover coverage in your area.

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