Does Medicare Cover Dental?
Medicare, the federal health care program for Americans over age 65, covers only a very limited number of dental services in very serious situations. How serious? Well, if you have cancer in your jaw and need teeth extracted to prepare for radiation treatment, that would be serious enough. Also, if you were preparing for kidney transplant, you can expect Medicare to help with the charges for a dental exam. Additionally, the official Medicare website vaguely states that a non-covered dental service MAY be covered if it is the result of, or a necessary part of, a covered dental service as long as it is performed by the same Medicare approved dentist.
Other than these specific situations, dental services are not covered by Medicare. Even though dental treatments can be an important part of keeping you healthy and pain free, Medicare does not pay any part of your dental cleanings, fillings, crowns, root canals or dentures. What about supplements? Don’t Medicare supplements pay for the things that are not covered by Medicare? No! Actually, Medicare supplemental policies (aka Medigap policies) assist you in paying for a part of a Medicare approved service, and not unapproved treatments such as dental care.
Now, the only time you could be seeing a Medicare policy providing certain dental services is if it is offered as a bonus for persons who enroll for a Medicare Advantage policy. Medicare advantage plans are not supplementing Medicare, however. These plans (also known as Medicare Part C plans) are private contracts with insurance companies or other health care organizations that are replacing Medicare Part A and B, instead of just filling in the gaps. The plans are usually designed as HMO or PPO plans with doctors and hospitals enlisted as network providers. Such plans will commonly require that you use the network for health services, or discourage out of network services with significantly higher costs.
When a Medicare Advantage Plan does offer any dental service, you can expect it to be quite limited. If you have a pre-existing health insurance condition, you’ll best opportunity to get coverage with low premiums comes during special open enrollment periods, such as when you turn 65. During open enrollment, Medicare Supplement insurance rates cannot be raised based on your medical history. In addition, best Medicare Advantage Plans or MA policies are renowned for permitting all previously existing health conditions except End Stage Renal Disease (ESRD). The more you learn about Medicare, Medicare Advantage Plans and Medigap Insurance, the better chance you have to get coverage that fits your situation at a low rate.