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Medicare and Dental Care: What’s Covered and What’s Not?

Experienced Medicare Broker Consulting with Client in Michigan

As we age, our dental needs change, and we may require more frequent visits to the dentist. Unfortunately, traditional Medicare does not cover most dental services, leaving many beneficiaries to pay out of pocket for these necessary expenses. However, there are some exceptions, and it’s important to understand what dental services Medicare does cover and what options are available to help manage the costs of dental care.

What Dental Services Does Medicare Cover?

Generally, Medicare does not cover routine dental care, including cleanings, fillings, extractions, or dentures. However, there are some exceptions for medically necessary dental services that are considered part of a covered procedure.

For example, if you need dental services as part of a covered surgery, such as jaw reconstruction or tooth extraction before radiation treatment for oral cancer, those dental services may be covered by Medicare. Additionally, if you have a medical condition that requires a dental procedure to treat, such as oral cancer or an injury to your jaw, Medicare may cover the dental services as part of your treatment.

Medicare Advantage Plans and Dental Coverage

If you’re enrolled in a Medicare Advantage plan, you may have access to additional dental benefits. Many Medicare Advantage plans offer dental coverage as part of their plan benefits, which can include routine cleanings, fillings, and other preventive services.

It’s important to note that dental benefits offered by Medicare Advantage plans can vary widely, so it’s important to review plan details carefully to understand what is covered and what your out-of-pocket costs may be. Some plans may require you to see a dentist within a specific network, or there may be limits on the number of visits or services covered each year.

Medicare Supplement Plans and Dental Coverage

Another option for managing dental costs is to enroll in a Medicare Supplement plan, also known as Medigap. These plans are designed to help cover out-of-pocket costs associated with traditional Medicare, including deductibles, copayments, and coinsurance.

While Medicare Supplement plans do not typically include dental coverage, some plans may offer additional benefits that can be used toward dental expenses. For example, some plans may offer a wellness benefit that can be used to pay for preventive dental services.

Private Dental Insurance

For those who need more extensive dental coverage, private dental insurance may be an option. Many private insurers offer dental plans that can cover routine cleanings, fillings, and other services not covered by Medicare.

It’s important to review the details of any dental insurance plan carefully, as there may be waiting periods, deductibles, or other restrictions that could impact coverage. Additionally, dental insurance plans may have network restrictions, so it’s important to ensure that your preferred dentist is in the plan’s network before enrolling.

Medicare and Discount Dental Programs

For those who need assistance managing dental costs but do not have access to dental insurance, there are also discount dental programs available. These programs offer reduced rates on dental services for members, often in exchange for an annual membership fee.

While discount dental programs can be a good option for some, it’s important to review the details of the program carefully to ensure that the savings are worth the cost of the membership fee. Additionally, not all dentists accept these programs, so it’s important to confirm that your preferred dentist participates in the program before enrolling.

Final Thoughts

While traditional Medicare does not typically cover routine dental care, there are options available to help manage the costs of necessary dental services. From Medicare Advantage plans to private dental insurance and discount programs, it’s important to review all available options carefully to ensure that you are getting the coverage you need at a price that works for you.

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What Our Customers Have To Say

Shecter Calendar
Shecter Calendar
2023-05-12
Very knowledgeable, friendly, easy to work with.
Cindy
Cindy
2023-05-11
Jim was a great resource who was recommend by my financial advisor. His explanations of the various options were straight forward and very informative. He asked me pertinent questions about my health in order to tailor a plan to best fit my needs.
beth swartz
beth swartz
2023-05-10
very knowledgable
Loventry Robinson
Loventry Robinson
2023-05-10
Jim is patient and very knowledgeable in his work. He helped me to get the Medicare advantage plan I wanted, and I am very satisfied.
Teresa Orr
Teresa Orr
2023-05-10
Jim was very helpful in explaining coverages and explaining the steps I needed to take to get Medicare. I highly recommend him. He is very knowledgeable on all aspects of care and made it easy for me to enroll in coverage.
Laurie Eisenbraun
Laurie Eisenbraun
2023-05-08
Jim was able to provide tailored Medical Gap policy solutions that fit my and my husbands individual needs. Jim is knowledgeable about all the potential policies that could work for us.
Denise Bensch
Denise Bensch
2023-05-04
I want to thank James Neil for making the Medicare Insurance sign up process so easy. He took what I thought would be a frustrating and confusing process, and made it a pleasure. He clearly explained our options and gave us information in an easy to understand manner. I will definitely recommend his services to friends and family.
Chris Bensch
Chris Bensch
2023-05-04
Mr. Neal is extremely knowledgeable & helpful. He did an excellent job of explaining how everything works and presented our options clearly. I'd strongly recommend anyone nearing retirement, considering a benefit change or simply looking for an overview of their options contact him.
Patrick Lennane
Patrick Lennane
2023-05-01
Awesome experience, explained all options clearly and made it easy to make a healthcare decision. Highly recommend!
KATHY TROHA-AUSTIN
KATHY TROHA-AUSTIN
2023-04-24
These two (Jim and Jennifer) were awesome. Extremely knowledgable about the entire process. Would highly recommend them.