Are you one of the 57 million Americans who receives health care coverage from Medicare?
If you’re new to Medicare or are beginning to rely more on its benefits, you might wonder: does Medicare cover dental?
You would hope it would. After all, dental care in the United States is expensive. The average annual per-patient spend on dental procedures in the United States was $685 in 2013. Costs have continued to grow over the past five years.
Unfortunately, Medicare itself doesn’t cover most aspects of dental care. Still, some options don’t require you to take out an expensive, private insurance policy.
Medicare is complicated, but dental care doesn’t need to be. Keep reading to find out what is and isn’t covered by Medicare dental plans and how to find supplemental dental insurance.
Does Medicare Cover Dental? Only in Hospitals
Medicare doesn’t cover all the basic dental procedures you might have enjoyed under private insurance.
It doesn’t cover:
- Cleanings
- Fillings
- Dentures
- Dental plates
- Tooth extractions
If it’s a standard type of care you’d visit your current dentist for, Medicare won’t help pay for it.
However, Medicare Part A – your Hospital Insurance – does cover certain dental when you’re admitted into the hospital. This coverage extends to dental services even if your doctor admitted you for something else.
It also pays for inpatient care if complicated or emergency dental procedures land you in the hospital. However, the dental care itself must come from your pocket.
Although Medicare covers big expenses like hospital stays, the costs of dental care is still a burden.
The ADA also notes that people with high dental costs make up a small percentage of the population. The services they get tend to be bigger procedures or infrequent care.
But if you live on a limited income, $685 might not be affordable, but neither is private dental insurance.
So what do you do if you want extra protection? You look for a Medicare supplement to cover dental costs.
Should I Forget About Dental Treatment?
If Medicare doesn’t cover dental hygiene and treatment, should you skip it? After all, almost everyone skips an annual cleaning or checkup at some point.
Forgetting dental care isn’t the best option because poor dental care can impact your health. Both doctors and dentists recognize that there’s a connection between how healthy your mouth is and your overall health.
Oral health contributes to other issues like cardiovascular disease. Research suggests that oral bacteria may be linked to inflammation and infections that contribute to clogged arteries, heart disease, and stroke.
Poor oral health is also a risk factor for endocarditis. Endocarditis is an infection that occurs when bacteria from another part of your body enter your bloodstream and attacks damaged areas of your heart causing an infection.
The bacteria causing endocarditis can come from your mouth.
Finally, your oral care needs change as you get older. Regular check-ups and timely treatments help ensure you keep your teeth as you grow older and also protect your gums and tongue from disease.
Choosing the Right Medicare Supplement Plan
Skipping a trip to the dentist isn’t an option. So, how do you pay for it? More importantly, how do you protect yourself if you end up needing a costly treatment?
Medicare supplements exist to patch the gaps in coverage that come with Medicare.
Choosing Medicare Advantage or Medigap
Medicare Advantage (Medicare Part C) may include plans that include routine dental care like cleanings as well as coverage for vision and prescription drugs.
But not all Medicare Advantage plans offer dental coverage. Part C is infamous for providing hundreds of plans with premiums and coverage that fall on a wide spectrum. You are also limited according to what’s available in your state or even local area.
Medigap insurance may cover some dental costs according to state regulations and specific plans. To buy Medigap, or Medicare supplemental insurance, you need to also pay for Part A and B.
Choosing Private Insurance
Do you still have access to your employer’s health insurance or your employer’s Medicare plan? Does your spouse have a dental plan? If so, these should be your first port of call when hunting down dental cover.
If you don’t have access, you can purchase private dental insurance. For some, the monthly premium may ultimately cost more than they spend on the dentist each year. However, you’ll pay lower out-of-pocket costs in the event of an emergency.
Plans come with different costs and restrictions according to insurer and state. Most standalone plans demand that you visit a dentist in the network because those dentists charge the insurance company lower fees than out-of-network dentists.
Private plans offering the most flexibility may come with a higher premium as well as a higher expectation that you’ll pay for more expenses.
Enroll in a Dental Discount Plan
Do you have a high standard of oral health but still want coverage for the basics? Consider a dental discount plan.
These discount plans are local organizations that provide a discounted rate for dental services for a monthly or annual membership fee. You’ll save between 20 and 60 percent of the cost of essential services like cleanings and exams as well as on major treatment.
Talk to Your Dentist
Unfortunately, the answer to the question “Does Medicare cover dental?” is no.
Finding Medicare coverage for dental when you’re retired is complicated in part because of the vast array of plans put before you. Patients looking for cover aren’t out of luck, but they’ll see coverage fluctuate according to the packages available in their area.
Are you over 65 and looking coverage? Are you a dentist who works with patients eligible for Medicare? Click here for more resources about financing for dentists on our blog.