Maintaining good dental health is essential to overall well-being, especially as we age. Unfortunately, Original Medicare doesn’t cover most routine dental care, such as cleanings, fillings, or dentures. However, you can get dental coverage through a Medicare Advantage plan or a standalone dental insurance policy.
In this chapter, we’ll explore Medicare’s dental coverage, available options, and how to ensure your dental health is taken care of.
Medicare’s Limited Dental Coverage
Original Medicare (Parts A and B) doesn’t typically cover routine dental services. However, a few exceptions exist where Medicare may cover dental care if it’s part of a covered procedure.
- Dental Services Covered by Part A
- Hospital Stays: If you need dental care as part of a covered procedure that requires a hospital stay, Medicare Part A may cover the hospital-related costs. For example, if you need dental surgery due to an accident, Medicare may cover the hospital stay but not the dental services themselves.
- Complications: In rare cases, Medicare may cover dental care if it’s needed to treat complications from a covered medical procedure, such as jaw reconstruction following surgery.
- Dental Services Not Covered by Part B
- Routine Care: Original Medicare does not cover routine dental care, including cleanings, fillings, extractions, dentures, and other common dental services. You’ll need to pay for these services out of pocket unless you have additional coverage.
Medicare Advantage Plans with Dental Coverage
Many Medicare Advantage plans (Part C) offer additional benefits beyond what Original Medicare covers, including dental care. If you’re concerned about dental expenses, enrolling in a Medicare Advantage plan with dental coverage may be a good option.
- What’s Covered: Medicare Advantage plans with dental coverage often include routine services like cleanings, x-rays, and exams. Some plans may also cover more extensive services like fillings, crowns, and dentures.
- Costs: Dental coverage through a Medicare Advantage plan varies depending on the plan. Some plans include dental benefits with no additional premium, while others may charge a higher premium. Be sure to review the details of any plan you’re considering to understand what’s covered and your costs.
Standalone Dental Insurance
If you prefer to stay on Original Medicare or your Medicare Advantage plan doesn’t offer dental coverage, you may consider purchasing a standalone dental insurance policy. These policies are designed to cover routine dental care and can help reduce your out-of-pocket costs.
- Coverage Options: Standalone dental insurance typically covers preventive services like cleanings and exams, as well as basic and major services like fillings, extractions, and dentures.
- Costs: The cost of standalone dental insurance varies depending on the plan and the level of coverage. Be sure to compare plans to find one that fits your budget and covers your needed services.
Dental Discount Plans
Another option to consider is a dental discount plan. These plans are not insurance but offer discounted rates on dental services at participating providers. Dental discount plans can be a good option if you don’t need comprehensive coverage but want to save on routine dental care.
- How They Work: With a dental discount plan, you pay an annual or monthly fee to access discounted rates on dental services. The discounts vary by provider and service but range from 10% to 60% off regular prices.
- Costs: Dental discount plans are typically more affordable than dental insurance, but they don’t cover the cost of services. You’ll still need to pay for your dental care out of pocket but at a reduced rate.
Key Mistake: Ignoring Your Dental Health
One of Medicare beneficiaries’ most significant mistakes is ignoring their dental health because they think it’s too expensive. Poor dental health can lead to other serious health problems, such as infections, heart disease, and diabetes. It’s important to prioritize your dental care, whether it’s through a Medicare Advantage plan, standalone dental insurance, or a dental discount plan.
Conclusion
While Original Medicare doesn’t cover routine dental care, options are available to help you manage your dental health. Whether you choose a Medicare Advantage plan with dental coverage, standalone dental insurance, or a dental discount plan, finding a solution that works for you is essential.
In the next chapter, we’ll explore Medicare’s coverage for home care services and how to ensure you get the support you need to stay home as you age.
Chapter 12: Medicare and Home Care