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Medicare And Dental Coverage, Everything That You Should Know

Medicare happens to be a federal health insurance program. It is mainly meant for people of 65 years of age and above. 

More than 60 million people rely on Medicare to meet their health insurance. It helps them cover their disabilities and other diseases. If you are reading this article, chances are that you are already signed-up for the Original Medicare plan.

Speaking of Medicare, it can be confusing to many people. Many people are not sure about what their Medicare plans cover for them. For instance, many of you want to know the details of dental insurance Medicare.

In this post, we will clear all your doubts about Medicare and dental

Does Medical cover dental costs?

If you are someone looking for dental care under your Medicare plan, the first question that pops into your mind is, does Medicare cover dental? Let’s clear it out for you.

The original Medicare plan does not cover regular dental services. This includes extractions, cleanings, and fillings. As you already know the Original Medicare Plan is divided into two parts, Part A and Part B.

Part A covers only certain emergency dental services when it is performed in a hospital. It may also cover services like an extraction to get the patient ready for radiation treatment. 

Part A or B can also include an oral examination that is required to perform before a kidney or heart valve transplant. However, this is applicable only in some situations.

In short, it can be said that the Original Medicare Plan doesn’t cover dental care services. But there are ways through which you can cover your dental care expenses under some of the Medicare plans which we will be discussing later in the article.

See, also: 4 Reasons you should never skip a dental checkup

What type of Medicare covers dental?

Now let’s talk about Medicare dental coverage plans.

Medicare Advantage Plans which is also called Part C is the combination of the Original Medicare Part A and Part B. These types of Medicare plans are provided through insurance companies that are approved by the government Medicare program.

Some of these plans also provide extra services and programs that are not covered by Original Medicare. Some plans could include Part D prescription drug coverage as well.

Just so you know Medicare Advantage Plans are similar to the traditional health plans in terms of coverage and cost. However, you should know that not all plans provide you Medicare dental benefits. This is why you need to check everything thoroughly, before you sign-up for it. 

If you want dental coverage under your Medicare plan, then you need to choose the Medicare Advantage Plan that includes dental coverage. At the same time, you should also check whether it is fitting your budget and needs.

Does Original Medicare (Part A & Part B) cover dental?

Does Medicare Part A cover dental? Does Medicare Part B cover dental? If you are unable to find answers to these questions, we are here to answer that for you.

As already mentioned above Original Medicare plan is composed of Part A and Part B. Only if you have suffered any severe injury, the Original Medicare plan will not cover your dental expenses. You should also know that the injury needs to affect your teeth, jaw, or mouth. Also, you need to be hospitalised. In situations like this Original Medicare plan may cover some of your dental care expenses.

Before you enrol under a Medicare plan, you should go through all their details including the terms and conditions. This will help you understand whether it will cover your dental expenses or not. 

What type of dental services are covered by Medicare?

Now the question is what dental services are covered by Medicare?

Well, you should be informed that only Medicare Advantage Plans (Part C) covers dental services. However, the plan does not cover all types of services.

The dental services listed below are the ones that are covered by Medicare Advantage Plans (Part C):

  1. Teeth cleaning
  2. Extractions
  3. Routine X-rays
  4. Fillings

However, you are still advised to go through all the details of the Medicare Advantage Plan before signing-up for it. That’s because the plans can differ based on your location and the insurance agency you are associated with. Also, you should be informed that dental coverage comes with many conditions on maximum cost allowances, how many services are covered in a year, and more.

How to get dental coverage?

To get routine dental care services like examinations, cleanings, extractions, and other services, you need to sign-up for an additional plan. 

Medicare Advantage Plans

Medicare Advantage plans include the same coverage that is offered by Part A and Part B. This type of Medicare plan is offered by private insurance companies. This is why they vary in terms of coverage and costs. Before you choose any plan make sure that you compare the plans carefully. This will help you decide that you are getting the right plan for yourself. 

Stand-Alone Dental Plans

You can also get a stand-alone dental care plan from a private insurance company. However, you should know that the plans may vary in terms of premiums, coverage, and deductibles. All these are dependent on the plan you select. 

Medicare Supplement Insurance Plans

Medicare Supplement insurance plans which are also called Part F does not cover routine dental care. They are meant to cover out-of-pocket expenses for the Original Medicare Plan. In other words, it covers all cost-sharing dental services for Plan A and B. For those who have Plan F, they need to sign-up for separate dental coverage.

As of 1st January, 2024 people who are new to Medicare are not allowed to buy plans that cover the Part B deductible. In other words, you can no longer get the Medicare Supplement Plans F and C. 

But for those who already have a Plan F, Plan C, they are allowed to keep it. If you were eligible for Medicare Plan before 1st January 2024, you can buy Medicare Supplement Plan F and Plan C. 

Does Medicare cover dental implants?

Another important question is, does Medicare cover dental implants? Let’s clear that for you as well.

Dental implants are considered to be the best and most natural way to replace broken or missing teeth. The implants that are used consist of artificial roots. With the use of the right technique, the artificial roots are made to bond with your natural bone to provide support for an artificial tooth. 

Dental implants are in use for decades now. They are safe to use for everyone. This is why they are so popular among people. Despite that these services are not exactly covered by Medicare. 

Even if some plans do cover them, they may vary depending on the plan you choose.

Dental care is very important for everyone, especially when you are ageing. By now you must have got an idea about the dental services that are covered by Medicare and the ones that are not. Just to remind you again, regular dental services are not covered by the Original Medicare plan. Dental services are only covered when you have suffered a severe injury affecting your jaw, mouth, or teeth. Before you enrol in any Medicare plan make sure you go through all the details.

FAQs

How to get dental care with Medicare?

Some of the plans under Medicare Advantage plans offer dental coverage. Medicare Advantage plans (Part C) include dental services like routine dental care. But before you enrol, you should check out Medicare Advantage plans in your area.

Are dental implants covered by Medicare?

Original Medicare Plan, Part A, and Part B do not cover dental implants. However, some of the Medicare Advantage plans may include some dental services.

What is Medicare?

Medicare is a federal health insurance program meant for people of 65 years of age or above. It covers the expenses of their diseases and disabilities.

What are the criteria to qualify for the Original Medicare plan?

To qualify for Original Medicare Plan, you must be:

  • A permanent legal resident in America for at least 5 years in a row.
  • You need to be 65 or older or have any sort of disability.

Zaraki Kenpachi

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