I will turn 65 soon, and I am enrolling in Medicare, but I am concerned about Medicare’s coverage of dental care. Does Medicare cover dental procedures? And if not, where can I get dental coverage?
-Dawn (Tulsa, OK)
Dear Dawn,
Medicare’s coverage of dental care is very limited. Generally, Medicare will not cover dental care that you need primarily for the health of your teeth or the parts of your body that support the teeth, like your gums and jaw. For example, Medicare will not cover routine checkups, cleanings, or fillings, and will not pay for dentures.
Medicare will cover some dental services if they are required to protect your general health, or if you need dental care in order for another health service that Medicare covers to be successful. For example, if you have cancer and need dental services that are necessary for radiation treatment, or if you need surgery to treat fractures of the jaw or face, Medicare will pay for these dental services. It will not, however, pay for any follow-up dental care after the underlying health condition has been treated. For example, if Medicare paid for a tooth to be removed as part of surgery to repair a facial injury, it will not pay for any other dental care you may need later because you had the tooth removed, and will not pay for dental implants or dentures to replace the extracted tooth.
Medicare Advantage Plans: Although dental services are mostly excluded under Original Medicare, some Medicare Advantage Plans do provide coverage for routine dental care. The costs and restrictions related to dental care vary from plan to plan. If you are considering joining a Medicare Advantage Plan, call the plan to find out what dental services, if any, it covers. Remember to make sure any Medicare Advantage Plan you’re considering covers the doctors and hospitals you prefer to use and the medications you take at a cost you can afford.
Medicaid: In some states, Medicaid covers some dental services. You may qualify for Medicaid if you have very limited income and assets. Check with your local Medicaid office to learn more about eligibility and to see what dental services are covered in your area.
Stand-alone dental plans: These plans cover dental services, and vary in cost and amount/type of services that they cover.
Local hospitals: Call the hospitals in your area to ask if they offer dental clinics, how you can become a patient, what services they offer, what the fees are, and if payment plans are available.