Medicare insurance plans can be confusing, especially if you’re trying to figure out what’s covered. Unfortunately, Original Medicare does not include dental coverage. However, there are some auxiliary Medicare coverage options for dental. Knowing the options available in your area will help you make informed decisions about your health care and budget.
Original Medicare includes Parts A and B and does not provide traditional dental coverage. However, if you’re hospitalized, Part A (hospital insurance) will pay for dental costs included in your hospitalization. For example, if you have a car accident that results in a broken jaw, Medicare Part A will cover those costs.
Medicare Part B covers preventive care and visits to the doctor, but not dental care or visits to dental specialists, such as oral surgeons or endodontists. If you need routine dental coverage for X-rays, cleanings, bridges, fillings, and other care, Original Medicare won’t pay for it. You’ll need to look into auxiliary dental coverage or a Medicare Advantage plan that includes dental.
Some Medicare Advantage plans (also called Medicare Part C) offer dental coverage. Medicare Part C is available through various private insurance carriers. Each state has different insurance carriers, and every carrier’s range of services is different.
Some Medicare Part C plans package dental, vision, and hearing together. Others offer just vision or just dental care. There may not be a plan in your area that has all of these benefits in one plan. If you think Medicare Advantage could be a good fit for you, SmartMatch can help you find the best plan to suit your preferences.
When comparing different Medicare Advantage plans, consider the range of services offered by the carrier. Some Medicare Advantage plans may help cover routine dental and common services, such as cleanings, oral lesion exams, root canals, periodontics, oral surgery, cavities, fillings, crowns, bridges, extractions, dentures, or treatment for infections. There may not be a plan in your area that has all of these benefits in one plan.
When reviewing plans, be sure to look at the coverage amounts and time limits. Some Medicare Part C plans will cap the total amount of coverage for each category. The plans may also require you to go to a particular provider in order to have the service covered. Because these plans are offered by private insurance carriers, there are provider networks that may limit your choice in providers.
There are some other ways you can access dental coverage through an insurance plan. One way is to buy a stand-alone dental care policy. These policies have separate monthly premiums and a variety of coverage options.
Another way to pay for dental care is with a Health Savings Account (HSA). While you can’t contribute more funds to this type of account if you’re on Medicare, you can still use any funds that are already in your account.
If you’re currently working, you can use a Flexible Spending Account (FSA) to pay for dental care. These funds are deducted from your paycheck with pre-tax dollars and can be used to pay for any type of dental care you need.
Finally, a Medigap plan may be an option for dental emergencies. Some plans offer coverage for the deductibles, copays, and coinsurance related to emergency dental services. However, they won’t pay for routine or preventive dental care. It is important to know, though, that you cannot be enrolled in both a Medicare Supplement (Medigap) plan and Medicare Advantage plan at the same time. Medigap can only be used with Original Medicare.
If you’ve always gone to an independent dentist office or dental specialist for your care, you may want to consider some other options to decrease your dental costs. A local dental clinic or a dental school may be more affordable. Local and state health departments may offer dental care or vouchers to help you pay for dental work. Some walk-in dental clinics may offer care to income-eligible individuals at no or a low cost.
Disclaimer:
The information provided in this blog post is intended for general informational purposes only and does not constitute medical advice. It is not a substitute for professional medical consultation or treatment. Always consult with a qualified healthcare provider for any questions you may have regarding a medical condition.
Enrollment in a plan may be limited to certain times of the year unless you qualify for a Special Enrollment Period or you are in your Medicare Initial Enrollment Period.
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