Does Medicare Cover Dental Services?
- Medicare Parts A and B don’t cover routine dental services, but many Medicare Advantage plans offer some dental benefits. Learn more about what dental services may be covered.
Original Medicare (Medicare Part A and Part B) offers many benefits seniors need to stay healthy, but the program also has some surprising gaps. Many beneficiaries, for example, may find out that Original Medicare does not include coverage for routine dental care and dentures.
Medicare beneficiaries are not without options for taking care of their teeth, however. Learn more about some of the options for dental services and benefits that may be available.
Does Medicare Cover Dental Care?
Original Medicare doesn’t include routine dental care as a covered benefit. However, some oral health services are available to Medicare beneficiaries under certain circumstances.
Incidental Dental Coverage Under Part A
Medicare Part A does include coverage for some dental services, provided they are performed in a hospital and are incidental to other needed treatments.
An example of covered dental care under Part A is reconstruction after oral cancer surgery. In this case, the dental care is not the primary focus of the treatment, but dental plate or implant services are part of making a full recovery from the surgery.
All dental services paid for under Part A must be incidental to other care in this way.
Some emergency services can be included under a Part A inpatient treatment, as when a beneficiary is admitted to the hospital with facial injuries, or in the very rare event that a privately paid dental treatment develops complications requiring hospitalization.
Part A generally cannot be used to pay for root canals, tooth extractions and other routine dental care.
Can Medicare Advantage Plans Cover Dental?
Medicare Advantage (Medicare Part C) plans are a popular alternative to Original Medicare, and many Medicare Advantage plans offer dental coverage for routine dental care such as teeth cleanings and allowances for dentures.
Beneficiaries who are eligible for Medicare may choose to sign up for an MA plan that includes all of the benefits covered buy Original Medicare, plus a few extra services not paid for by Original Medicare.
Part C plans in many states offer dental insurance as a covered benefit, though monthly premiums vary between policies and coverage limits may be in place. As always, only a qualified plan representative can provide definitive answers about the dental coverage a specific Medicare Advantage plan provides.
Alternative Dental Insurance Plans for Medicare Beneficiaries
Older adults are not limited to traditional Medicare for dental care. Many other options exist in the healthcare marketplace, some of which are available at low or no cost to seniors.
Stand-Alone Dental Insurance
Seniors whose Medicare coverage doesn’t include a dental benefit are generally free to buy into a stand-alone dental plan for themselves. Many insurance companies offer these plans for eligible seniors, and some even offer plans tailored for Medicare beneficiaries.
Discount Cards and Other Options
Seniors with limited income, especially those who live in states where Medicaid doesn’t offer dental benefits, may need to seek other options for adequate dental help.
Several states offer dental service cards as a low-income support for seniors. These cards may be presented at participating dental offices and clinics as part of the payment for services. Terms vary by the state and by the program, so it may be best to speak with a social worker or case manager before applying for a discount card.
Even in places without discount programs or where no affordable options exist for seniors, many older adults can still get free or low-cost dental care.
In many cities, free dental clinics provide extractions and fillings at no cost to beneficiaries. These clinics may be in high demand, and seniors can expect long wait times at most of them.
Other no-cost options can include dental fairs or other events put on by local dentists and dental colleges, where dental professionals offer exams, cleaning services, simple extractions and other basic services at no cost.