What’s the relation between Medicare and Dental Coverage?
Usually, Original Medicare (Part A and B) does not cover routine dental coverage. But the following are some notable exceptions:
For instance:
- If you are in need of a heart or kidney transplant or other complex procedure, that involves a preliminary dental exam.
- If you need a hospital stay because of an emergency or complicated dental procedure.
- Medicare would pay for medical reconstruction if you have an injury to your jaw.
A Medicare Advantage may allow you to receive dental coverage. Other coverage options outside of Medicare include dental discount cards and Dental Insurance.
Here is what Original Medicare (Part A and B) generally will not cover:
- Bridges
- Crowns
- Dental exams
- Cleanings
- Fillings
There are exceptions to this rule though.
Tip: With a Medicare Advantage plan, you can integrate coverage for routine dental care with other hospital and medical coverage. If you plan on keeping your Original Medicare, then examine if you want to add a separate dental plan or a Medigap plan with dental benefits.
For instance, if you have a disease that affects the jaw, Medicare may pay for a tooth extraction that is directly correlated to or by the disease. Also, if you had an accident to the jaw that would require medical reconstruction, then Medicare will cover that as well.
If any dental procedures require a hospital stay, then Medicare Part A will not cover the dental procedure but will cover the hospital stay.
Medicare can cover a dental exam. This happens if you’re having a heart or kidney transplant or other complex procedure that has to have a preliminary dental exam. Whether an in-office physician or hospital staff performs the dental exam will determine if the coverage will be under Medicare Part A or Medicare Part B.
Normally, you will be in charge of the full amount of your dental care unless you have other dental insurance. This is because Original Medicare does not cover routine dental care.
TIP: Enroll in a separate dental plan or a Medicare Advantage plan that offers covers dentures if you may need dentures. Medigap and Original Medicare do not cover dentures.
How you can get Dental coverage through Medicare Advantage plan
Some Medicare Advantage plans may allow you to get dental coverage.
Here are the added benefits Medicare Advantage plans (Medicare Part C) can include:
- Medicare prescription drug coverage
- Routine dental
- Routine vision
Additional dental coverage options
You will usually have to pay the full cost for routine dental care if you do not enroll in a Medicare Advantage plan that includes routine dental coverage.
But, you can use dental discount cards and dental insurance to cover dental costs outside of what’s covered by Medicare.
Be aware that Medicare is not a part of these types of dental coverage.
How you can use dental insurance
Request a free quote if you want complete dental coverage. You will be able to buy and learn about a dental insurance plan that best helps your needs.
If you or your spouse is employed, then you may have a group dental insurance plan. Carefully go over the dental plan if you have one. You may be required to stay inside a network of dental care providers if that is the plan’s rules. For this in-network plan, the premiums can be a little higher, but because you will be paying lower out-of-pocket fees, the costs will be offset. These fees include deductibles, coinsurance, and copayments. In-network dentists will usually discount their rates to beneficiaries in the dental plan. You may have to pay more service charges if you do not have an in-network plan but you’ll be able to go to any licensed dental professional.
How you can use dental discount cards
You can get dental discount cards by some dental care provider organizations if they offer it. There are not benefits receivable to the dentist or you and this is neither dental nor Medicare coverage.
You can use your dental discount card with a network of dental professionals who agree to discounted service rates. These services include fillings, cleanings, dental exams, and more.
With a dental discount card, you will pay one annual fee to be in the program. Use the card whenever you get dental care.
If you want to know more information about whether your dental provider offers discount cards then contact him or her.