Original Medicare does not cover dental services unless they are required as part of a more extensive medical concern. If you receive routine dental care, you will be responsible for 100% of the costs with Original Medicare.
However, Medicare beneficiaries have several options available to them to fill this gap in coverage. Whether you keep Original Medicare, enroll in a Medicare Supplement plan, or opt for Medicare Advantage, additional coverage for dental services is available. Below, we review your options.
What Dental Services Does Medicare Cover?
Original Medicare does not cover oral surgery, dentures, dental implants, routine care, or any other dental service. The only scenario in which Original Medicare will provide dental coverage is if your physician deems the dental procedure medically necessary as part of another service Medicare covers.
Because Medicare does not cover dental services, more than half of all Medicare beneficiaries do not have any source of dental coverage. This means they are likely not going to the dentist on a regular basis but if they are, their out-of-pocket expenses are probably high.
As you age, dental care becomes an important part of maintaining good health. By attending annual dental exams, you can prevent several health conditions. Thus, a lack of coverage means seniors are generally not receiving adequate preventive dental services.
To combat this, several dental insurance options are available to Medicare beneficiaries. Many Medicare Advantage plans offer policyholders basic dental coverage as an additional benefit to their health coverage, and stand-alone dental plans are an option when you enroll in Medicare Part A and Medicare Part B.
Dental Coverage with Medicare Advantage
When you apply for Medicare Part C, most plans offer dental benefits to policyholders. However, there are several Medicare Advantage plans that do not offer these benefits. Dental benefits are not the same from one plan to another, so when enrolling in coverage, be sure to review your plan’s notice of coverage to ensure you will receive the benefits you prefer.
When enrolling in a Medicare Advantage plan, you also want to be sure a dentist in your area will accept your plan’s dental coverage. Many Medicare Advantage plans restrict their enrollees to a network of doctors and their dental coverage can be even more restrictive.
To ensure a local dentist accepts the plan, research beforehand. Most carriers offer an online provider lookup tool that can be useful when enrolling in coverage.
Dental Coverage with a Medicare Supplement
Medicare Supplement plans only provide coverage after Medicare pays. Because Medicare will not cover dental services, neither does your Medicare Supplement plan. However, there are ways to keep the benefits of a Medicare Supplement plan and simultaneously receive dental coverage.
When you have a Medicare Supplement plan, the option for a stand-alone dental plan is the best choice for receiving high-quality dental coverage. In addition to dental coverage, most stand-alone plans often offer additional benefits as well. For example, Cigna’s dental plan also offers coverage for hearing and vision.
These ancillary plans involve an additional monthly premium. However, paying the premium for coverage is often less than what you pay in a year’s time going to the dentist uninsured.
Many top-rated Medicare Supplement carriers also offer a dental option. However, you do not have to receive dental coverage from the same insurance company as your Medicare Supplement.
Enrollment into stand-alone dental plans is simple. There are no health questions, and most plans are guaranteed issue. Some plans may require a waiting period for major services, but many offer preventive care from day one.
How to Find the Best Medicare Dental Coverage
Finding the best dental insurance to accompany your Medicare coverage does not need to be difficult. First, assess your needs. Once you know what you are looking for, you can begin researching carriers to help narrow down your options.
Keep in mind, just because one plan works for someone else, that doesn’t mean it is best for you. Once you find the right plan, enrollment is simple. Contact a licensed agent to enroll in minutes. For most plans, coverage can begin as soon as the next day,