As an insurance policyholder, it is important to know which services are covered and the benefits you can receive. For example, many people wonder, “Does Medicare cover dental?” Therefore, Medicare members should know whether or not their plans offer dental insurance. Understandably, paying costly out-of-pocket expenses for dental care can be concerning. In addition, a lack of knowledge of Medicare’s dental coverage options can be distressing as well.
In this article, we will discuss what you need to know about Medicare and potential dental plans. With proper information, you can make the right decision regarding dental care.
Understanding Medicare’s Dental Coverage
Medicare, a health insurance program administered by the federal government, assists eligible individuals in receiving comprehensive medical care. For most individuals, they will enroll in Original Medicare (Parts A and B). Part A provides hospital and inpatient services. Meanwhile, Part B offers medical and outpatient services. Alternatively, you can also enroll in Medicare Advantage Plans (Part C). With this plan, you receive benefits from Original Medicare and potential additional services.
It should be noted that Original Medicare does not act as a dental plan. Unfortunately, dental services are not considered a health essential. However, certain Medicare Advantage Plans do provide dental benefits.
What is Included in Medicare’s Dental Coverage?
With different Medicare plans available, it can be confusing trying to find the best coverage plan. Luckily, an experienced insurance professional can guide you throughout this journey and provide fully accurate information. Each Medicare plan provides a varying level of dental care. For example, certain plans may not offer any dental benefits, while other plans do provide dental insurance.
Medicare Part A
To start, Medicare Part A does not provide coverage for routine dental procedures. In fact, dental procedures are not covered even if services are performed in a hospital. However, in rare instances, Part A can offer limited dental insurance. For example, there are covered dental services for oral examinations before kidney transplant surgery. Furthermore, limited dental coverage can be provided for jaw reconstruction operations. While a lack of prominent dental insurance can be concerning, it should be stated that most Part A does not have a monthly premium.
Medicare Advantage Plans (Part C)
Based on the Medicare Advantage Plan you choose, Medicare may cover dental services. Typically, these plans offer coverage for preventative dental procedures such as routine cleanings and X-rays. Also, you can receive increased dental benefits for more extensive dental procedures. However, this will most likely result in a more expensive monthly premium. Regardless, increased monthly premiums can still be more affordable than purchasing a separate dental insurance plan.
Cost of Dental Care Coverage in Medicare
The cost of dental care can vary based on your insurance plan. While Medicare Part A monthly premiums are standardized, Advantage Plan monthly premiums can fluctuate depending on your plan type and location. As stated by Forbes, a Medicare Advantage Plan with dental care in Los Angeles can be more expensive than in Eastern Pennsylvania.
Of course, a dental insurance plan that offers greater dental benefits will have a higher monthly premium. Dental costs should play an important factor. However, for most, a plan that provides coverage for basic dental procedures is more than sufficient. To learn more about Advantage Plans that offer dental benefits, consider speaking to a licensed health insurance professional.
Medicare Supplement Plans
Medigap is a type of supplemental plan sold by private insurance companies. These plans can cover costly out-of-pocket expenses. To be eligible, you must be enrolled in Original Medicare (Parts A and B). It is important to note that Medigap only pays for benefits offered by Traditional Medicare, and it does not cover dental costs. Therefore, dental services will typically not be covered. However, certain insurance companies offer Medigap policies with limited dental insurance. This will lead to a higher monthly premium. Also, if you are a Medigap member, you are not allowed to enroll in Medicare Advantage.
Program for All-Inclusive Care for the Elderly (PACE)
In addition to Medigap, PACE is another viable supplemental insurance plan. Primarily, its purpose is to help seniors receive extensive health coverage while staying at home. Once you enroll in PACE, you are no longer eligible for Medigap. Furthermore, your monthly premiums will depend on your state of residence and financial circumstances. For those who qualify for Medicaid, they will not need to pay PACE monthly premiums.
Which Medicare Plan Gives Better Dental Coverage?
Simply put, Medicare Advantage Plans offer better dental benefits. Unlike Medicare Part A, these plans can provide coverage for preventative dental services and extensive dental procedures. With that being said, Advantage Plans can be more expensive as you must pay monthly premiums. However, for the dental insurance you receive, it can be worth it. By working with a knowledgeable health insurance agent, you may be able to find the right coverage plan. They can help you navigate through different plans and their varying dental benefits.
Getting Additional Coverage For Your Dental Needs
Instead of depending on Medicare Part A or Advantage Plans, you can purchase a separate dental insurance plan. While you must think about dental costs, you will be receiving comprehensive dental coverage. Plus, you don’t need to worry about dental benefits offered by Medicare.
Frequently Asked Questions
Why doesn’t Original Medicare cover dental?
Original Medicare does not provide dental coverage because dental procedures are not considered essential health benefits. Therefore, you can purchase a dental plan from a private insurance company.
Does Medicare Part B cover dental extractions?
No, Medicare Part B does not cover extractions or most dental services. However, dental insurance is offered in limited situations. Typically, it is provided when deemed medically necessary or in preparation for a covered service.
What is the best dental insurance for seniors on Medicare?
This will depend on the need and potential dental costs. If you do not require extensive dental services, then Medicare Advantage is a suitable option. However, for greater dental coverage, you should consider enrolling in a private dental insurance plan.
Does Medicare cover dental surgery?
Yes, Medicare covers these types of dental procedures on very rare occasions. However, it may be best to purchase a separate dental plan.
Want to Learn More?
At Health Plans of NC, it is our mission to help you find the best health coverage plan. In fact, with assistance from our licensed agents, you can find a plan that offers quality dental insurance at an affordable price. Also, they can help you find a suitable dental plan. For more information, give us a call at 800-797-0327. We look forward to helping you!