Does Medicare Cover Dental Care?
Does Medicare cover dental treatments and services? This guide will cover everything you need to know about Medicare and dental care coverage.
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What Dental Work Is Covered By Medicare?
When it comes to oral health care coverage, your Medicare options may be limited.
The only time Original Medicare may cover some dental work is if you get into a major accident and have to be hospitalized for a traumatic injury affecting your jaw, teeth or mouth.
Otherwise, your best bet for dental care coverage is a Medicare Advantage plan. Also known as Medicare Part C, Medicare Advantage combines Original Medicare (Part A and Part B) into one plan. Medicare Advantage plans are offered through private insurance companies approved by Medicare.
Do All Medicare Advantage Plans Cover Dental Care?
Keep in mind not all Medicare Advantage plans cover dental care. Before you enroll, review the plan to ensure it offers dental coverage that fits your oral health needs.
You can explore other ways to cover dental costs outside of what's covered by Medicare or Medicare Advantage plans. Those options include private dental insurance and dental discount plans.
What is Private Dental Insurance?
Private dental insurance allows you to buy an individual dental insurance plan that fits your oral health needs. You may already have private dental insurance or group dental insurance through your employer or your spouse's employer.
Dental insurance plans work like regular health insurance. Some policies require you to stay within a network of dental care providers.
The premiums may be a bit higher for this type of plan, but the cost of dental care is offset by lower out-of-pocket costs that include copayments, coinsurance and deductibles. The reason for this is because network dentists agree to charge discounted rates to members of the dental insurance plan.
Some private dental insurance plans also allow you to go to any licensed dentist of your choice.
What are the Costs Associated with Private Dental Insurance?
Like health insurance, with a dental insurance plan, you or your employer pay a monthly premium. After the deductible is reached (if there is a deductible), the insurance pays all or part of your qualified dental expenses, up to a stated maximum.
The insurance company generally pays the dentist directly for its share of your dental expenses. While preventive care (routine checkups, cleaning, etc.) is usually covered in full or nearly in full, you will have to pay a portion of the cost for more extensive dental care.
Some plans may require you to pay the dental care bill upfront and then request reimbursement from the insurance plan. With other plans, you may be required to pay a percentage of the total cost.
Also, some plans will have a schedule of benefits with set costs for certain dental procedures. It's best to assess your dental care needs and do a thorough review of all of the dental insurance plan options available to you.
What are Dental Discount Plans?
Some dental care providers offer dental discount plans or cards. These plans call for you to pay the total cost of your dental care. There are usually no deductibles, no waiting periods and no annual maximums. However, you have access to a network of dentists who have agreed on discounted rates for basic care such as cleanings, fillings, and exams. Typical discounts range from 10% to 60% for normal dental work.
If you know you're going to need extensive dental work, a dental insurance plan with benefit caps and waiting periods might not be the best option. A dental discount plan might be a better option as it can save you much more than the cost of its membership fee, especially if you need several dental procedures during the year.
In most cases, dental discount plans cost less than $150 per year. This means that you can benefit from even small discounts on a few major dental procedures. However, please be mindful that even with a dental discount plan, you will still have to pay a significant amount of the cost of dental care.
It's important to note that a dental discount plan is not part of Medicare. As mentioned earlier, all costs come out of your pocket. If you find a dentist you like, you can ask if they offer a dental discount plan and discuss actual charges with them to determine how much you will save.
Sharrarne Morton taught English and journalism in higher education for 16 years and enjoys writing about finance and healthcare.