Medicare doesn’t cover dental care. However, there are options for dental either on your policy or as a stand-alone coverage option.
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. Below, we’ll discuss the best dental insurance for seniors with Medicare and what it covers.
Does Medicare Cover Dental
Medicare doesn’t 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 have coverage through Medicare.
However, you had to have a dental procedure to treat another medical condition; it might be covered by Medicare.
Dental procedures done in a hospital inpatient may have coverage; however, your abscess tooth might not have coverage.
When does Medicare cover dental care? Here are the answers to some of the top questions.
Does Medicare Cover Dentures
No, Medicare doesn’t cover dentures. However, some Medicare Advantage plans through private insurance companies may cover dentures.
Does Medicare Pay for Oral Surgery
Medicare usually doesn’t 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 in a hospital on an inpatient basis.
- Part B pays for oral surgery; a non-dental condition has coverage by Part B if the surgery and treatment are at the same time, by the same doctor.
- For example, Medicare pays for reconstructive jaw surgery after a car accident.
- Medicare pays for teeth removals to get the jaw ready for radiation treatment for jaw-related neoplastic disease.
- However, even where Medicare pays for surgeries, it won’t pay for follow-up care or additional dental procedures.
Does Medicare Cover Dental Exams
Medicare doesn’t cover routine dental exams. However, it will cover dental exams performed as part of an overall review 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. The American Dental Association recommends you follow your dentist’s cleaning schedule and make 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 won’t pay for either invisible aligners or more traditional braces. However, Medicare will pay for dental splints and wiring after jaw surgery.
Does Medicare Cover Wisdom Teeth Removal
An oral surgeon removes wisdom teeth in an outpatient procedure.
These routine extractions are dental procedures Medicare won’t cover.
There are a few instances where wisdom tooth removal might have coverage by Medicare.
If the teeth removal is a requirement before beginning radiation treatment for neoplastic disease, the removal will have coverage.
Also, if wisdom teeth removal in an inpatient hospital setting, the cost of hospitalization will have coverage.
And if the wisdom teeth removal is going to treat an underlying medical condition, the removal will probably have coverage.
Does Medicare Cover a Dental Abscess
Neither Part A or Part B have any standard dental coverage. Standard dental includes regular cleanings and x-rays, crowns, root canals, fillings, or tooth extractions.
In some cases, however, Medicare will pick up the claim if you were to have an accident that would require reconstructive jaw surgery.
Or if you have jaw cancer and may need a tooth/teeth removed to receive treatment. Then Medicare would consider this medically necessary and pick up coverage for that specific treatment.
There are three types of dental abscesses which include:
- Periapical abscess: when the infection occurs in the “soft pulp,” of the tooth.
- Periodontal abscess: Periodontal abscess is when the infection occurs in the bone tissues that support the structure of the tooth.
- Gingival abscess: Gingival abscess is when the infection only affects the gum and surrounding tissue area rather than the periodontal ligaments or teeth.
Which type of dental abscess you have will determine the types of symptoms you experience as well as the location in which those symptoms are experienced.
Symptoms of a dental abscess vary but are generally easy to spot.
Treatment for Dental Abscesses
If you feel as though you may be suffering from a dental abscess, you’ll want to consult with your dentist as soon as possible.
A doctor cannot treat an actual abscess, but in some cases, when your dentist is not available, the MD can provide treatment for the symptoms. An antibiotic, for instance, or pain medications.
There are several treatments for dental abscess through a periodontal surgeon or dentist. Cutting out the abscess is one option that involves cutting out and draining the bacteria.
The second form of treatment is by having a root canal. A root canal entails drilling into the tooth and “root canal,” the bad part of the tooth gets clean. It is then re-sealed with a rubber-like cement.
With periodontal abscesses, the abscess needs to be cleaned and drained. After which the root surfaces are smoothed out below the gum line. Then, the tooth heals and prevents any further infection.
In severe cases, the diseased tissue may have to be surgically removed after reoccurring dental abscesses have caused damage. And in some cases, the tooth may have to be surgical extracted.
Does Medicare Supplemental Insurance Cover Dental
There’s no Supplement that provides dental coverage. Since Medicare doesn’t cover dental, Medigap won’t either.
Medigap, also known as gap insurance, can take care of many healthcare costs that are not paid by Parts A and B, including deductibles and coinsurance.
Get Dental Coverage for Seniors
There are two ways to get dental coverage. The first is to enroll in a Medicare Advantage plan that offers dental benefits.
Part C is private insurance that’s an alternative to Medicare. It provides all the benefits of Parts A and B, and sometimes additional benefits.
The other way to get dental coverage is to buy standalone dental insurance.
Dental insurance is affordable and is often on the same plan as vision and hearing insurance.
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 dental plans in your area today.
Find out what standalone senior dental plans are available in your area by completing our online form or calling us at the number above.