Does Medicare Cover Dental for Seniors?
Key Takeaways
- Most Medicare Advantage plans include options for dental coverage.
- If you have Original Medicare or Medicare Advantage without a dental plan, you can add one.
- Medicare Part A covers certain dental services when you’re in a hospital. Part A can also pay for inpatient hospital care if you need to have emergency dental procedures.
Original Medicare (Parts A and B) typically does not cover routine dental services. The only exceptions are when dental services are a necessary part of another covered procedure or a hospital stay is required. Medicare Advantage, on the other hand, often bundles dental insurance for seniors.
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What Dental Services Are Covered by Medicare?
If you have Original Medicare (Parts A and B), your dental care is covered only in specific cases. Medicare may pay for:
- Dental services that are necessary to perform another covered procedure
- Tooth extractions before radiation treatments for neoplastic disease
- Oral exams before kidney or heart valve replacement
- A hospital stay if your dental procedure requires it
Does Medicare Cover Dental?
No. Despite several recent expansions to Medicare policies, adding Medicare dental insurance for seniors wasn’t one. As of this year, Medicare dental coverage is minimal.
Why Is Dental Care Not Covered by Medicare?
Dental has always been excluded from the Medicare system and is not considered one of the 10 Essential Health Benefits under the Affordable Care Act (ACA). The only change came in 1980 when Congress created an exception for inpatient hospital services. Since then, Part A may help cover your hospital stay following a dental procedure.
What Medicare Dental Plans Are There for Seniors?
Dental coverage is not one of the federally funded parts of Medicare. That said, if you are over 65, there are plenty of ways to get dental insurance for seniors. Here are your options:
Stand-Alone Dental Plans for Seniors
If you have Medicare, private insurance companies provide dental plans. Like health insurance, you can shop for different plans and pick the coverage options you need. If you have Original Medicare (Parts A and B), or a Medicare Advantage plan that doesn’t include dental coverage, you can add a policy separately. Keep in mind that means you’ll also be responsible for that plan’s copays, coinsurance and deductible.
Medicare Advantage Plans That Include Dental Insurance for Seniors
Medicare Advantage (Part C) is an alternative to Original Medicare. It substitutes for Original Medicare (Part A & B), offering the same benefits and coverages. In addition, Medicare Part C often bundles services like hearing, vision, prescription drug coverage, and dental coverage.
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How Do I Get Dental Coverage With Medicare?
Now you can answer the question: Does Medicare cover dental? The next step is to figure out how to find dental insurance for seniors and enroll.
If you have Original Medicare or Medicare Advantage without dental coverage: You can add a separate dental policy whenever you need it.
If you want to enroll in a Medicare Advantage plan with dental coverage: You can start a Medicare Advantage plan at various times known as enrollment periods.
Here are the dates to know:
- Enroll during your Initial Enrollment Period (IEP): This is a seven-month window around the month you turn 65. The IEP is your first chance to enroll in Medicare.
- Medicare Part C & D Annual Enrollment Period: Original Medicare enrollees can switch to a Medicare Advantage plan with dental insurance during this open enrollment period held annually from October 15 to December 7.
- Medicare Advantage Open Enrollment Period: If you already have a Medicare Advantage plan, you can switch to a different one from January 1 to March 31. That means you may be able to find dental coverage that better meets your needs.
How to Find Dentists Who Accept Your Medicare Plan
There are several ways to find a dentist who accepts your coverage. Remember, if you only have Original Medicare (Parts A and B), your dental care probably isn’t covered.
- If you have stand-alone dental coverage, contact a dental office to confirm that they will accept your insurance.
- If you have Medicare Advantage, check with your carrier to make certain you have dental coverage included in your plan that your dentist accepts.
- If you’re signing up for Medicare Advantage, let your licensed insurance agent know that you need dental coverage. If you don’t have an agent of record, give GoHealth a call. We’ll show you which Medicare Advantage plans include dental services, which practices are covered, and how much it all costs.
What Is the Best Dental Insurance for Seniors on Medicare?
The answer here is based entirely on you. Start by considering your needs and budget. Some dental plans for seniors cover a lot but come with high monthly premiums; others are cheaper but don’t provide the same coverage for dental services.
When trying to find a dental plan that works for you, here are some things to consider:
- Check out your plan’s provider network. This is the group of dentists and other providers who have agreed to accept your dental insurance.
- Does your spouse have a dental plan through their employer? If so, you may be able to join their plan.
- Are there dental discount plans available? While these aren’t insurance, their paid memberships come with dental services at discounted rates.
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Sources
- Medicare Dental Coverage. cms.gov.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.