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Traditional Medicare does not cover the cost of dental work unless you suffer a traumatic injury that affects your face or jaw, and you are hospitalized.
Many optional Medicare Advantage plans do offer dental coverage, including preventative and comprehensive dental work.
Original Medicare consists of two parts: Hospital, which is Part A, and Medical, which is Part B. The only time that original Medicare will pay for dental work is if you suffer a traumatic injury that also affects your teeth, mouth, and/or jaw and had to be hospitalized.
According to the Centers for Medicare & Medicaid Services, “Medicare doesn’t cover most dental care, dental procedures, or supplies, like cleanings, fillings, tooth extractions, dentures, dental plates, or other dental devices. Medicare Part A (Hospital Insurance) will pay for certain dental services that you get when you’re in a hospital. Part A can pay for inpatient hospital care if you need to have an emergency or complicated dental procedure, even though it doesn’t cover dental care.”
Although dental care is rarely covered under Medicare Parts A & B, 88% of Medicare Advantage, or Medicare Part C, plans include some sort of dental coverage. These plans are offered through private insurance carriers that combine Original Medicare Part A & Part B into one plan that must be approved by the Medicare program. These plans may offer extra programs and services that are not covered by Original Medicare, such as dental coverage, hearing coverage,
allowances for over-the-counter health items and more.
By now you’ve learned that when it comes to dental services, only dental work that related to a traumatic injury during hospitalization will be covered under original Medicare. But what kind of dental work is covered by Medicare Advantage? While each Medicare Advantage plan is different, many plans offer coverage for the following services:
Medicare Advantage dental benefits are not standardized, so it is important to thoroughly review the summary of benefits for your plan to know exactly which procedures are covered, your maximum dental allowance, how many services are covered in a plan year, and more.
Approximately 2/3 of all Medicare beneficiaries don’t have dental coverage. This number is especially alarming because 51% of people age 65 and older have visited a dentist within the last year, and about 20% of them spent over $1,000 out of pocket. While you should always check with your dentist for exact pricing for different dental services, we’ve included a list below of dental services that may be covered under a Medicare Advantage plan, as well as the average cost of that service.
If your Medicare plan doesn’t cover dental services and dental coverage is important to you, you may need to find a new plan. Medicare allows its beneficiaries to make changes to their plans during the annual enrollment period, which runs between October 15th and December 7th of each year. However, you may qualify for a special enrollment period if any of the circumstances below apply to you.
In addition to dental coverage, Medicare Advantage plans can offer other benefits that don’t come with standard Medicare, including vision coverage, transportation to and from doctor’s appointments, over-the-counter medication allowances, help with hearing aids, and more. A Medicare Advantage plan will cover everything that is covered in Medicare Parts A and B, with options offering additional benefits, so if you enroll in a Medicare Advantage plan you could get much more than you would by just enrolling in Parts A and B alone.
If you’re interested in learning more about Medicare Advantage or are concerned that traditional Medicare won’t provide all the coverage you need, connect with a live agent at (800) 950-0608.