Medicare Dental Plans

Original Medicare usually does not cover dental related services unless it is for certain circumstances. However, there are many other options for dental coverage including dental insurance plans, discount dental plans and some Medicare Advantage Plans.

What Dental Services Does Medicare Cover?

Original Medicare Parts A and B do not cover dental care. This means that there is no Original Medicare coverage for things such as cleanings, fillings, tooth extractions, or dentures. Medicare beneficiaries are responsible for their own routine dental care and procedures. There are additional coverage options to assist with dental care for Medicare beneficiaries, such as dental insurance, dental discount plans, and included dental benefits on some Medicare Advantage plans.

How Do I Get Dental Coverage with Medicare?

There are a few different ways in order to obtain dental coverage when enrolled in Medicare:

  • Stand-alone dental insurance plans
  • Dental discount plans
  • Medicare Advantage plans with included dental benefits
  • Dentist office specific contracts 
Does Medicare Have a Dental Plan?

Medicare does not offer a specific Medicare dental plan. There are some Medicare Advantage plans that include dental coverage as part of the plan's coverage, but these are offered through private insurance carriers, not through Original Medicare directly. There are also stand-alone dental insurance plans, as well as discount dental plans offered independently through insurance carriers. 

What Dental Services does Original Medicare cover?

Original Medicare (Part A and B) will cover limited dental services if required to protect your general health or prepare for a procedure that Medicare covers.

For example, Medicare will pay if:

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  • You receive an oral exam in the hospital because you will be receiving a kidney transplant or heart valve replacement.
  • You have a disease that involves the jaw and need dental services to receive further treatment.
  • You need ridge construction after the removal of a face tumor.
  • You need surgery to treat fractures of the jaw or face, or require dental splints and wiring after receiving jaw surgery.

Medicare Supplement plans help cover costs that are not fully covered by Original Medicare. If you receive dental care as listed above and still have copayments or deductibles that need to be paid, your Medicare Supplement plan may pay the majority, if not all, of those expenses. However, keep in mind that Medicare Supplements will only cover costs related to what Original Medicare covers. In other words, if Medicare does not cover a specific service, neither will your Medicare Supplement.

Even if you receive coverage for these services, Medicare will not pay for any follow-up dental care after your health condition has been treated. Medicare will also not cover regular checkups, cleanings, fillings, dentures, or most tooth extractions.

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What Dental Coverage do Medicare Advantage Plans Include?

Certain dental services can be covered by Medicare Advantage Plans, but make sure to ask your plan provider which services will be covered, for each plan may be different. It would be best if you also asked your dentist to confirm which plans are accepted.

Take note that the more coverage a plan offers, the higher your premiums, coinsurance, and copayments could be.

How Do I Get Dental Coverage with Medicare?

Although Original Medicare does not provide dental coverage, there are still options available to help with the cost of routine dental services and procedures. If you remain with Original Medicare and a Medigap plan, typically you will look at two options for additional dental coverage:

  • Dental Insurance: Dental insurance plans are plans that enrollees pay a monthly premium toward for a certain specified benefit amount for the year. Some dental plans may also have a deductible. The coverage under dental insurance is based on the level of care: preventative, basic, or major. Your plan may have a coinsurance or copayment based on the level of care. Many dental insurance plans will also offer additional coverage for vision or hearing benefits. 
  • Discount Dental Plan: Dental discount plans are typically paid as an annual fee, rather than a monthly premium. These plans work off of pre-negotiated rates with in-network providers, and do not provide reimbursement to the dentist’s office. Essentially, these plans offer discounted rates on dental services. 

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Give us a call at 877-88KEITH (53484), an experienced agent will walk you through the different dental coverage options available to you.

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