Does Medigap Cover Dental Care?

Medicare Benefits Solutions
Nov 8, 2020

Medigap or Medicare Supplement, insurance plans help pay for the cost of some expenses not covered by Original Medicare. Most often, Medigap is used to defray the cost of deductibles, co-pays, coinsurance, and the cost of healthcare when traveling outside of Medicare coverage areas, including international travel. While this can benefit you if you have regular medical expenses, you may be wondering whether or not Medigap can help with coverage for services like dental care.

What Does Original Medicare Cover?

Before looking into Medigap insurance and whether not or not these plans cover dental care, it’s first important to address what Original Medicare does and does not cover when it comes to the health of your mouth. While Original Medicare does not provide routine coverage for dental care, you may be able to have some care provided under the right circumstances.

Generally, Original Medicare will provide coverage on a limited basis for medically necessary dental surgery and some dental care afterward. You will not, however, be able to receive coverage on an ongoing basis for teeth cleaning, fillings and other services related to dental care.

Does Medigap Cover Dental Care?

Because Medigap is designed to help offset costs not covered by Medicare, you might think that Medigap would provide dental services since dental care is not typically covered by Original Medicare. Unfortunately, Medigap is meant to fill in the gaps for costs incurred when utilizing Medicare, meaning it is supplemental insurance coverage and not comprehensive health insurance.

As a result, Medigap does not cover dental care either in the traditional sense of an insurance product. Medigap may, however, help pay for costs associated with dental care that is covered by Medicare by providing payment to meet coinsurance requirements related to services involving dental care before, during, or after an approved oral surgery.

Medigap and Emergency Dental Care

You might also be able to benefit from Medigap coverage if you end up needing emergency dental care. This may be the situation when you suffer a serious injury to your mouth or when a dental condition causes a major medical concern. In these cases, you may need care as an inpatient in a hospital setting where Medicare Part A would apply toward the cost of services. Medigap may be able to cover the cost of your Part A deductible, and if coinsurance is required, Medigap may be able to cover that as well.

To understand the limitations of your coverage and your own financial liability related to Medigap and dental care coverage, please speak with your plan administrator. You might also consider working with your dentist and your primary care physician to find ways to utilize your benefits appropriately in cases where dental care or associated costs can be covered by Medicare and Medigap plans.