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Does Medicare Cover Dental Services?

Dental coverage is a common concern for people transitioning into the Medicare program. As a senior entering this stage of life, you have options with how to proceed with your dental care. Let’s take a look at what your options are.

What Dental Care Is or Isn’t Covered by Medicare?

Anything that your doctor deems “medically necessary” will fall under your Medicare coverage, but here are some clear cut examples of work that is or isn’t covered.

Covered: 

  1.  Jaw reconstruction surgeries

Jaw reconstruction can often come with necessary tooth extractions, dental splints, wiring, ridge reconstruction, fracture repairing services, and potentially other work. All of these are covered if your provider requires it be done as part of your jaw work. 

  1. Services provided during a hospital stay

Only work that is necessary due to the reason for your hospital stay falls under this category. Voluntary procedures that have to be done as an inpatient or that you want to have done while you are there do not qualify for Medicare coverage.

  1. Required oral examinations

Many transplants or replacements require an oral examination before you are cleared for the procedure, so those are covered under your Medicare policy.

  1. Dental services related to oral cancer treatments

Not Covered: 

  1. Oral surgery
  2. Dentures or dental implants
  3. Oral exams/teeth cleanings
  4. Root canal, wisdom tooth, or abscess tooth removals
  5. Orthodontics

Options for Getting Dental Coverage

Medicare Advantage 

Only some Medicare Advantage plans include any dental benefits. The ones that do include some parts of dental care and have a different variety of what that entails; some offer only the standard care services, others have a wider range. Dental procedures are sometimes included in a Medicare Advantage plan, but it is a toss-up. 

Stand-alone Dental Plans

A private, separate plan can be obtained through a private insurance company outside of Medicare. These can cover different amounts of basic services, preventative work, along with emergency/major care, and usually have different costs, waiting periods, and exceptions. 

Private dental insurance can often come in various packages along with any combination of hearing, vision, and other specific insurance policies. 

Dental Discount Plans

This option is very different from the rest as it is not an insurance policy. Rather than being insured and relieved of costs through a provider, these plans allow you to get discounts from certain providers after paying an up-front membership fee. 

Dental discount plans are usually limited to a network of dentists, but are more likely to lower costs for all kinds of dental services. This is a better option if you are needing dental work done short-notice since there is no waiting period for how long you have to be enrolled before using the discounts.

Have More Questions? Let Us Help!

Navigating dental and Medicare coverage can be confusing. Here at My HealthCare Direct, we want to help you compare your options and ensure you get the proper dental insurance that you need. Call us today for more information!

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