What Dental Services Are Covered By Medicare?

In order to understand the relationship between Medicare and dental services, it is necessary to have a basic understanding of the two plans. Both Medicare Supplement and Parts A and B of the original Medicare program provide coverage for most common oral health care procedures and medications that are deemed necessary for safe living. The goal of Medicare is to provide seniors with quality of life, but with a limited amount of resources. As Medicare has grown, so has the number of providers that participate in the program. Because of this increase, some patients are not being covered for certain services because there are not enough providers to accommodate the demand.

One service that has been greatly affected is the coverage for in-home medical care. Over the past decade there has been a steady decline in the percentage of individuals who can actually afford to pay for their own dental care. While it is always best to take advantage of any available coverage, it can be difficult knowing what is offered through Medigap and Medicare. In order to avoid facing financial difficulties when it comes to routine dental care, it is often recommended that senior citizens utilize both programs.

When it comes to dental coverage through Medicare, it is necessary to understand how the program works. Unlike most other insurance plans, Medicare does not offer any coverage for routine dental care or treatments. There are a few exceptions to this rule. Some prescription drugs and certain dental procedures are deemed eligible for in-home treatment under certain circumstances, which means that your regular dentist may be able to fill the need.

Seniors that are enrolled in a Medicare Part D plan or a Medicare Advantage plan may be eligible for in-home treatment at their own dentist, in-network specialists, or through a Medicare Part B supplement. Depending on your specific situation, your provider could also bill you for the service. Most Medicare dental plans do not cover braces, teeth extractions, crowns, or other cosmetic treatments. If you have vision insurance, it may cover some or all of these services under specific conditions. Before deciding on which service is best for you, speak with an independent medical professional who is knowledgeable about the differences in the various Medicare programs.

Medicare Part A covers dental expenses up to a maximum annual limit of $600 per person, per year. Seniors that join Medicare part A as early as possible should consider enrolling in a discount dental plan that provides significant savings on coverage over traditional fee for service plans. Depending on the state you reside in, the specifics for obtaining Medicare coverage will vary. It is important to remember that if you choose to use Medicare part A, it will not cover all of your routine expenses. You will still need to obtain supplemental insurance to pay for additional dental care.

Medicare Part B, which is meant to cover dental expenses not associated with Medicare Part A, can be obtained through private insurance companies, through a Medicare prescription drug benefit, or from a provider that participates in the Medicare program. Medicare part b does not cover dental services, so if you need such coverage you will need to obtain it outside of the program. In order to be completely covered by Medicare for all of your out of pocket dental expenses, you will need to receive both part a and part b. To find out what plan is right for you, speak with an independent Medicare specialist who can help you understand your options.