Does Medicare Cover Dental Care?

Medicare Benefits Solutions
Jul 20, 2020

Medicare coverage can be a confusing topic to navigate. This is especially true when it comes to understanding what is and isn’t covered under different types of Medicare plans. Oral health can be an important part of your overall well-being, so understanding your insurance coverage of any dental-related care can help you plan for routine visits and care when you have a medical need.

Unfortunately Original Medicare Part A and Part B won’t pay for routine dental care, such as yearly check-ups, X-rays and teeth cleanings. It also won’t pay for dentures, extractions, and fillings. The good news is that there are ways to get a form of dental coverage under some Medicare plans. 

Medicare Advantage plans and dental coverage

Also known as MA or Part C, Medicare Advantage plans combine your Part A and Part B benefits with additional coverage. Private insurance companies offer MA plans and are approved by the government’s Medicare program. MA plans usually offer additional services and programs that Original Medicare doesn’t have, and this often includes dental coverage. Some plans may have vision coverage and Part D prescription drug coverage. 

These MA plans may include PPOs, POS plans, HMOs, and more, and will differ in costs and coverage. You will likely have to pay a monthly premium, coinsurance, copays, and a yearly deductible. Not all MA plans include dental coverage. Compare the MA plans available in your area and find the one that meets your specific dental care needs.

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When Original Medicare may cover dental

Original Medicare includes Part A, hospital insurance for when you’re formally admitted, and Part B, medical insurance for outpatient procedures. They both have deductibles, and you’ll usually be responsible for 20% of the Medicare-approved costs unless you have a secondary insurance. Original Medicare may cover dental work needed as a result of a traumatic injury that impacts your teeth, jaw, or mouth. If you have to be hospitalized as an inpatient to treat it or require doctor visits, Original Medicare coverage might cover some of the costs incurred.

Dental care covered by Medicare Advantage

MA plans often include routine dental care, but services may include:

  • Extractions
  • Fillings
  • Teeth Cleaning
  • Routine X-rays

Your plan could differ based on things like your location or the insurance company that offers it. Additionally, there are typically limits to how much your insurance will cover and how many visits you can have every plan year.

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