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Dental implants, like most dental services, are not covered by Original Medicare.
For more dental coverage, including coverage for dentures and dental implants, seniors may wish to explore the Medicare Advantage plans available in their area.
Medicare Advantage plans replace Original Medicare and often offer more benefits than Medicare Parts A and B alone.
Do you need dental coverage? Make sure you’re covered for the care you need by calling (800) 950-0608 to speak with a licensed agent. We’ll help you find the best Medicare dental insurance plan near you.
So, are dental implants for seniors paid by Medicare? Well, Original Medicare provides two types of coverage to any given Medicare beneficiary: Part A covers any care received in the hospital and Part B covers all other forms of medical care. Dental services, including dental implants to replace lost or damaged teeth, are not generally included.
Original Medicare will only pay for dental work when a traumatic injury resulting in hospitalization affects your teeth, mouth and/or jaw, and you must receive dental care in the hospital. If you are enrolled in Medicare Parts A and B alone, this typically means that dental implants for seniors on Medicare will not be covered in full, and you will likely have to pay completely out-of-pocket for dental implants and other types of dental care received from a dentist.
Seniors over the age of 65 are more likely to suffer from tooth loss than you may think. The older you get, the more statistically likely it is that you may experience some form of tooth loss.
According to reports from the National Institute of Health, 27.27% of seniors above 65 have no natural teeth left. This number rises to 31.30% in seniors above 75 years old. Many others are missing at least one tooth or several teeth, sometimes in sections, due to natural wear and tear, poor maintenance, illness, or injury. Smokers and those with low income are among the populations most greatly affected.
Missing teeth cause a variety of health and wellness problems for seniors. Not only can missing teeth affect your smile, they can also lead to deterioration in facial structure and loss of bone, affecting your overall appearance and self-confidence. More importantly, missing teeth make it more difficult for seniors to eat and communicate.
Sometimes, dental care can be administered through dental procedures like root canals. Additionally, tooth loss can be successfully corrected with appliances like dentures or the even more effective dental implants, which are by far the most natural solution. Unlike dentures, dental implants are permanent forms of tooth replacement that can be cared for like real teeth, with regular flossing and brushing. They are virtually undetectable and allow seniors to eat and speak normally.
But dental implants and even dentures are often prohibitively expensive to afford without any kind of coverage, and because Medicare does not cover dental implants, many seniors choose to deal with the effects of tooth loss on their own.
If you’re a senior who has already experienced some untreated tooth loss or who already wears dentures and is interested in upgrading to a permanent solution like dental implants, a Medicare Advantage plan with enhanced dental coverage may be the right option for you. With the right Medicare Advantage plan, the answer to the questions, “are dental implants covered by Medicare?” and, “does Medicare cover implants for seniors?” may very well be yes.
Does Medicare cover the cost of dental implants?” You may be pleased to learn about Medicare Advantage plans, or Medicare Part C plans, which are optional alternatives to Original Medicare that often include dental benefits. These plans, which are provided by private insurance carriers, must cover the same health care services that are included in Parts A and B, but generally offer additional coverage that varies from plan to plan.
Enrolling a Medicare Advantage plan that includes dental coverage, including coverage for Medicare dental implants for seniors, can give older individuals who are worried about tooth loss and other dental problems peace of mind.
It’s important to thoroughly review the benefits of any health insurance plan before purchasing. Use our free online tool to compare plans or call (800) 950-0609 for assistance from a licensed Medicare Advantage agent.
If you’re asking yourself “does Medicare cover oral surgery?”, you may be surprised to learn that the answer to this question actually depends on several factors. Original Medicare alone usually does not cover any form of dental care or oral surgery. Still, there are a few situations when certain types of dental surgery may be covered.
Certain forms of reconstructive dental or oral surgery may be covered under Original Medicare if these surgeries are considered to be medically necessary as a result of injury or disfigurement.
Dental surgery services may also be considered medically necessary when they are needed prior to another Medicare-covered procedure, such as doctor-ordered tooth extraction as a precaution for heart surgery. Likewise, a person with cancer of the mouth may receive coverage for a dental procedure that is considered to be medically necessary prior to radiation treatment.
It is important to note that even if Original Medicare does offer some coverage for medical expenses associated with dental surgery services, there is no scenario where Original Medicare will cover dental needs that are not considered by your doctor to be medically necessary (such as routine teeth cleanings or dentures).
Furthermore, any dental surgery that is not ordered by a doctor as preparation for other covered medically-necessary procedures will typically not be covered under Original Medicare Parts A and B. This includes dental needs such as fillings, crowns, root canals, dental implants, etc.
Even though tooth loss is a common problem for seniors, dental implants are not covered by Original Medicare. The only time Original Medicare coverage for dental implants is applicable is when you suffer a traumatic injury that effects your mouth and teeth and you require dental care or dental procedures while in the hospital.
Dental implants and other appliances that treat tooth loss are expensive, often prohibitively so if you are paying for these appliances and their installation completely out of pocket. Seniors who have already experienced tooth loss or who are concerned that they may experience tooth loss in the future should absolutely consider enrolling in a Medicare Advantage plan that offers comprehensive dental coverage.
If you are concerned about getting the coverage you need from Medicare or want to learn more about your potential Medicare monthly premium, call us at (800) 950-0608 or send us a note with your contact information. We’re happy to help you find a plan that meets all your dental needs.