Older adults have an increased risk of dental problems from tooth decay, gum disease, decreased saliva production and even medications. That means you can expect to have more dental procedures and expenses as you get older.
Does Medicare Cover Dental?
Medicare does not cover dental care except in certain specific circumstances. A good rule of thumb is this: if your dental expense is related only to a dental procedure – such as a filling for a cavity — it won’t be covered by Medicare. If, however, you had to have a dental procedure in order to treat another medical condition, it might be covered by Medicare. Dental procedures performed while you are a hospital inpatient may also be covered.
When does Medicare cover dental care? Here are answers to some of the top questions.
Does Medicare Cover Dentures?
Dentures – a removable set of artificial teeth – can replace some or all of your natural teeth, helping you to look better and chew food more easily. Dentures can be expensive, sometimes costing up to $10,000. But dentures are never covered by Medicare.
Does Medicare Pay for Oral Surgery?
Medicare ordinarily does not pay for oral surgery in a dentist or oral surgeon’s office or outpatient facility. However, there are a few exceptions:
- If the surgery must be performed in a hospital on an impatient basis, Medicare Part A will pay your hospitalization costs, but not the fees for the dentist and other healthcare professionals.
- Medicare Part B will pay for oral surgery that is a necessary part of the treatment for another, non-dental condition that is covered by Part B, if the surgery and treatment are performed at the same time, by the same dentist or doctor. For example, Medicare will pay for reconstructive jaw surgery after a car accident.
- Medicare will pay for teeth extractions to get the jaw ready for radiation treatment for jaw-related neoplastic disease.
However, even where Medicare pays for surgeries, it will not pay for follow-up care or additional dental procedures needed because of the surgery.
Does Medicare Cover Dental Exams?
Medicare does not cover routine dental exams. However, it will cover dental exams performed as part of an overall exam before a kidney transplant or heart valve replacement. If a covered exam shows that you need fillings or other dental procedures, those procedures will not be covered by Medicare.
Does Medicare Cover Dental Cleanings?
Regular dental cleanings are essential to good oral health, and the American Dental Association recommends that you follow your dentist’s recommendations for a cleaning schedule and regular dental visits. However, Medicare doesn’t pay for teeth cleaning.
Does Medicare Cover Invisible Aligners?
Invisible aligners are a less-noticeable alternative to traditional metal braces for straightening teeth. Medicare generally will not pay for either invisible aligners or more traditional braces. However, Medicare will pay for dental splints and wiring after jaw surgery.
Wisdom teeth are typically removed by an oral surgeon in an in-office procedure. These routine extractions are considered dental procedures that are not covered by Medicare.
There are a few instances where wisdom tooth removal might be covered by Medicare. If the teeth must be removed before beginning radiation treatment for a neoplastic disease, the removal will be covered. In addition, if the wisdom teeth must be removed in an inpatient hospital setting, the cost of hospitalization will be covered by Medicare Part A. And if the wisdom teeth must be removed to treat an underlying medical condition, the removal will probably be covered.
Does Medicare Supplemental Insurance Cover Dental?
Medicare Supplement, or Medigap, insurance, can take care of many healthcare costs that are not paid by Original Medicare Parts A and B, including deductibles and coinsurance. But there is no Medigap plan that provides dental coverage.
There are two ways for Medicare enrollees to get dental coverage. The first is to enroll in a Medicare Advantage plan that offers dental benefits. Medicare Advantage (Part C) is private insurance that’s offered as an alternative to Original Medicare. It provides all the benefits of Parts A and B, and it may offer additional benefits, including dental coverage.
The other way to get dental coverage is to buy a standalone dental insurance for Medicare recipients. Dental insurance is affordable and is often packaged with vision and hearing insurance, to cover three of the most common healthcare expenses that are excluded from Medicare.
To find the best dental insurance for seniors and get a quote in your area online, click here. Our agents are licensed in your state and can help you compare Medicare dental plans in your area today. Our services are 100 percent free and there is no obligation to sign up. Find out what standalone senior dental plans are available in your area by completing our online form or calling us at the number above.