If you’re a Medicare beneficiary, you might wonder if dental services are covered. Unfortunately, Original Medicare doesn’t cover routine dental. But, you can buy a dental plan alongside Medicare to pay for cleanings, exams, and dental care. Another option is an Advantage plan with dental benefits. We’re here to help you make the right decision for your dental care needs and explain when Medicare covers dental services.
Does Medicare Cover Dental Care?
Medicare doesn’t cover routine dental care such as cleanings, fillings, root canals, and extractions. Part A and B will only cover dental services if they’re necessary for another medical procedure. For example, Part B may pay for a dental exam before a kidney transplant or heart valve replacement. Further, Part A covers tooth extractions as part of reconstructive jaw surgery after an accident. Almost all dental care falls outside these narrow exceptions.
If you want help paying your dental bills, you have three options:
- A Medicare Advantage plan, including dental coverage
- A standalone dental plan
- A dental discount plan, which isn’t insurance, but gives you a discount on services
Does Medicare Cover Oral Surgery?
Some dental plans cover gum surgery. If you have one of these plans, you’ll probably have to pay a percentage of the bill. Most dental plans also will only pay up to a certain amount in claims each year. If you’re having dental surgery because of an accident or jaw cancer, Medicare may cover your surgery.
Does Medicare Cover Dentures?
Medicare doesn’t cover dentures, but some dental plans do. Insurance may not pay 100% of dentures’ cost, but it can help lower the bill. If you need dentures, look for a plan that includes denture coverage.
Does Medicare Cover Dental Implants?
Some Medicare dental plans cover dental implants. Implants can be an excellent alternative to dentures. You can, however, expect to pay part of the cost of any major dental work. Your dental plan may have a limit on the amount it will pay out in claims each year.
Does Medicare Cover Wisdom Teeth Removal?
Medicare won’t pay for wisdom teeth removal, but some dental plans will. As with any other major dental procedure, you’ll probably have to pay part of the cost.
Does Medicare Cover Oral Exams?
No, Medicare won’t cover an oral exam. But, some companies sell Medicare dental plans – either alone or bundled with Advantage. Each company is different, and some only carry benefits. Even the most basic plans should cover preventive services like dental exams and x-rays. Sometimes you’ll have a copay.
Your insurance may pay the full cost of an exam, or you may have to pay part of the bill. Your plan may also require you to choose a primary dentist or use the dentists in the network.
If you need a dental exam because you’re having a kidney transplant or heart valve replacement, Part B may cover your exam, but it won’t cover any dental work you need.
Does Medicare Cover Teeth Cleanings?
Medicare won’t cover dental cleanings. But, basic dental cleanings are a service that most dental plans cover. A dentist may suggest an in-depth cleaning if you have gum disease or haven’t had your teeth cleaned in a while. Most likely, you’ll pay more for these types of cleanings.
Does Medicare Cover Invisible Aligners?
Invisible aligners like Smile Direct Club help straighten teeth but aren’t as noticeable as braces. Medicare won’t cover invisible aligners. But, some insurance companies usually treat aligners the same as braces. If your dental insurance includes orthodontic work, it will typically cover aligners.
With that said, it may be hard to find insurance that includes adult orthodontic coverage. If you do, you can expect to pay a percentage of the cost. Another option is to buy into a dental discount program that offers a discount on aligners.
Does Medicare Cover a Root Canal Treatment?
Original Medicare doesn’t cover root canal treatments. Advantage plans with dental coverage often include partial or full coverage for such procedures. You’ll likely have to use a dentist in the Advantage plan’s network.
Does Medicare Cover an Abscess Tooth?
An abscess is an infection in your gum or at the root of a tooth. If you develop an abscess, your dentist may perform a root canal treatment or pull the tooth. The dentist may also prescribe antibiotics. Many dental policies cover root canal treatments, but you’ll have to pay part of the cost. Your Part D plan should pay for antibiotics your dentist prescribes. If the infection spreads and becomes more severe, Part B will cover a doctor’s care, and Part A will cover hospitalization.
Does Part C Cover Dental?
Some Advantage plans include dental insurance, and others don’t. Coverage can vary. Some plans cover only standard services, and others cover a wide range of dental procedures. Research plans, so you understand what’s included before signing up. Advantage plans often include vision and hearing benefits as well.
How to Get Dental Benefits on Medicare
Many people find dental bills go up as they get older. Crowns, extractions, gum surgery, implants, and dentures are costly. A good dental plan can help you stay on top of cleanings and make it easier to afford major procedures.
Dental plans can cost as little as $9 and range to $63+ per month. However, the average plan is about $35 per month. Humana dental plans are some of the most popular among seniors on Medicare.
Also, an indemnity solution we offer costs about $1 a day and there are no networks for dentists, audiologists, or optometrists. To learn about the details, give us a call at the number above.
We can help you find the policy that's best for you. From dental insurance to Medigap coverage, we can walk you through everything you need. Just call the number above or fill out our online rate form.