How to Get Dental Coverage with Medicare

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How to Get Dental Coverage with Medicare

 

How to Get Dental Coverage with MedicareMedicare does not cover routine dental care. It doesn’t cover cleanings, fillings, or any of the usual dental procedures. It doesn’t pay for extractions or dentures. In general, you are responsible for the cost of all your regular dental care.

Medicare will pay for certain dental procedures related to a covered medical condition. For example, it will cover jaw reconstruction after an injury or extractions before cancer radiation therapy. These select covered dental procedures must be necessary to treat a non-dental condition. They must be performed at the same time as treatment for the covered condition and by the same doctor or dentist.

Medicare Advantage with Dental

Many Medicare Advantage plans offer dental coverage, as well as vision, hearing and prescription drug coverage—all in one plan.

Medicare Advantage plans are private plans offered by Medicare-approved insurance companies. The plans combine all the coverage of Medicare Parts A and B and may have additional benefits, such as dental. You must be enrolled in both Part A and Part B to join a Medicare Advantage plan. Medicare Advantage is also called Medicare Part C.

Coverage and costs with Medicare Advantage vary from plan to plan. With some plans, you pay no additional premium. (You must continue to pay the Part B premium to Medicare.) Other plans may charge a premium, and some charge extra for dental or other additional benefits. In addition, every Medicare Advantage plan has a service area—a geographic area in which it operates. You must live in the service area in order to join a plan.

You can research Medicare Advantage plans in your area using the Plan Finder at Medicare.gov. You may also want to ask your dentist what plans he or she participates in. Some Medicare Advantage plans require you to use a provider that’s part of their contracted network.

Other Dental Options

If you want to stay with Original Medicare and receive your benefits directly through the federal government, then your dental options are limited. You can:

  • Pay out-of-pocket for all your regular dental care needs
  • Buy a private dental insurance plan
  • Look for low-cost or discounted dental services

Some dental and dental hygiene schools have clinics that allow students to gain experience while providing quality care at a reduced cost. Experienced, licensed professionals supervise the students. You can check with the American Dental Association and the American Dental Hygienists Association to see if there is a school near you.

Your state or local health department or United Way chapter may be of help in locating low-cost dental care in your area. In addition, the Bureau of Primary Health Care, a service of the Health Resources and Services Administration  (1-888-Ask-HRSA), supports federally-funded community health centers across the country that provide free or reduced-cost health services, including dental care.

For more information, contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048. If you have questions about Medicare Made Clear, call 1-877-619-5582, TTY 711, 8 a.m. - 8 p.m. local time, seven days a week.

Resources

Medicare.gov: Visit the official U.S. government site for Medicare and use the Plan Finder tool.

Medicare Advantage Coverage: Learn more from Medicare Made Clear.

 

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