Medicare does not cover most dental care, routine procedures such as cleanings, fillings, or extractions, or dental supplies like dentures, plates or devices for treating teeth.
Program beneficiaries can use Medicare Part A, which covers inpatient and hospital care, for certain services related to the mouth:
- May pay for certain dental services that the patient needs to receive during their hospital stay.
- You can also take care of inpatient hospital care if you need to undergo complicated or emergency dental procedures, even if the dental care itself is not covered.
Medicare was not originally designed to include routine dental care; therefore Medicare coverage of dental expenses is limited to situations where dental treatment is an integral part of other medical treatment. For example:
- An extraction before radiation treatment for oral cancer or
- Reconstruction of the jaw after an accident
Unfortunately, if you do not have other insurance, the out-of-pocket cost for dental procedures is 100%.
Some beneficiaries decide to buy a Medicare Advantage or Medigap plan that covers dental procedures. But this means spending more money a month on premiums.
For low-income seniors who are dual eligible, Medicaid may provide limited dental benefits, but coverage varies considerably from state to state..
About two-thirds of Medicare beneficiaries do not have an alternative dental plan. More than 20% of adults 65 and older have untreated cavities.
Dental problems left to your own devices can carry greater health risks.
Options for “senior” dental treatment
- Dental Life Network is a national nonprofit program with volunteer dentists that especially helps improve the dental health of vulnerable populations, people with disabilities, and older adults.
- Some community health centers have dentists on their staff floor. They usually offer free services or a scale according to the patient’s salary.
- The dental schools they also have services performed by advanced students.
- Many dental offices offer payment plans, and facilities to pay for treatment in installments.
What is it and who qualifies for Medicare
Medicare is a federal health program that covers people 65 and older; certain younger people with disabilities and patients with advanced kidney disease.
As of 2020, Medicare has 44 million beneficiaries. But enrollment is expected to rise to 79 million by 2030.
The program is made up of three parts that cover different services:
- Medicare Part A (hospital insurance). CSome inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
- Medicare Part B (health insurance). Cudre certain medical services, outpatient care, medical supplies, and preventive services.
- Medicare Part D (prescription drug coverage). It helps cover the cost of prescription drugs, including many vaccines or recommended vaccinations.)
When you enroll in Medicare, you must choose what type of coverage you want. There are two options:
Medicare Original. IIncludes Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). The beneficiary pays for the services as they are received. When you receive services, you pay a deductible at the beginning of each year, and you generally pay 20% of the cost of the Medicare-approved service, called coinsurance. If you want drug coverage, you can add a separate drug plan (Part D).
This type of Medicare pays for much, but not all, of the cost of covered health care services and supplies. A Medicare Supplement Insurance (Medigap) policy can help pay for some of your remaining health care costs, such as copays, coinsurance, and deductibles.
Some Medigap plans also cover services that Original Medicare doesn’t cover, like medical care when you travel outside of the United States.
Medicare Advantage. These “integrated” plans include Part A, Part B, and usually Part D. Most plans offer additional benefits that original Medicare does not cover, such as vision, hearing, and dental care. Medicare Advantage plans have annual contracts with Medicare and must follow Medicare coverage rules.
Each Medicare Advantage plan may charge different out-of-pocket costs. They may also have different rules about how to get services.
He Medicare Open Enrollment Period It runs from October 15 to December 7 of each year.
Sources: Medicare, American dental Association, Dental Life Network.