The prevalent belief is that only oral injuries, complicated or emergency procedures requiring hospital stays, and pre-transplant dental exams are covered by standard Medicare. Indeed, Medicare dental does not cover many of the routine services such as teeth cleaning, routine evaluations and X-rays, fillings, and teeth extractions. However, we have found that certain procedures deemed necessary to improve quality of life can often be included through the Part B program of Medicare dental coverage. These procedures are often some of the most expensive procedures, therefore the potential for coverage through Medicare dental is an important factor to consider.
At our dental clinic, we focus on comprehensive family dentistry that provides the widest range of services for every member of your household. This not only means that we offer many specialized procedures that typical dental offices do not, it also means that we accept many insurances that other dentists turn away, including Medicare dental.
In order to minimize out-of-pocket costs for our senior patients, our staff are extensively trained to be well-versed in all of the intricacies of Medicare dental coverage through Medicare Part B. If there is a way to get your procedure covered, you can be sure that we will find it! Our dentists are also highly specialized in many of the common Medicare dental procedures such as dental implants and oral surgery so you can rest assured that you are in good hands!
does medicare pay for dental?
While Medicare does not pay for many of the routine dental services such as teeth cleaning, routine evaluations and X-rays, fillings, and teeth extractions, there are some important procedures that are covered. These include any oral surgery or reconstruction required to correct the effects of trauma or injury as well as treatment for certain oral conditions that are considered to be affecting quality of life of the patient. In the large majority of cases, a thorough evaluation by your dentist is necessary to determine your eligibility for coverage of the specific treatment under Medicare dental.
Does medicare cover dentures?
Though there may be some rare exceptions, Medicare does not typically cover dentures. However, there is some good news for patients who already have dentures that they are not entirely satisfied with. One of the most common procedures we perform at our dental clinic for our Medicare patients is dental implants. If you are a Medicare patient looking to transition from dentures to dental implants, or if you are missing multiple consecutive teeth, there is a good chance that you are eligible for Medicare dental through Medicare Part B. We can provide you with an evaluation to help determine your eligibility for coverage and start you out on your journey toward a brighter smile and healthy eating!
does medicare cover oral surgery?
One of the most common types of oral surgery that is covered by Medicare dental is dental implants, as mentioned above. Medicare also does cover other types of oral surgery, namely those procedures that are required to correct trauma from injury or conditions assessed to be affecting the patient’s quality of life. Some of these conditions may include TMJ disorder, bone atrophy, bone growth abnormalities, and sleeping disorders such as sleep apnea. Sleep apnea may be treated with oral surgery in some cases, or by use of a mouthguard that is custom-made by your dentist. Contact our dental clinic today for an evaluation to see if your oral surgery procedure can be covered through Medicare dental!
While there are some very important (and big ticket) procedures that can be covered by your Medicare dental through Medicare Part B, there are limitations in its ability to provide coverage for routine procedures. Patients may want to consider other options to supplement or replace their standard Medicare Part A and B in order to receive more comprehensive coverage. Three of the most commonly considered dental insurance options for seniors are presented below:
Medicare Advantage (part C)
Medicare Advantage plans, also known as Medicare Part C, is a complete plan that is an alternative to the standard Medicare Part A and B. The program consists of a large variety of plans offered through government-approved private insurance companies. Like traditional health plans, each Medicare Advantage plan is unique and should be read thoroughly to ensure you choose the one that is right for you. Be aware that not all Medicare Advantage plans cover dental, and those that do may have an annual cap or only cover certain procedures.
Medicare supplement insurace
Also known as Medigap, the Medicare Supplement Insurance plan can be added to your Medicare Part A and B to pay for all or part of your copayments, coinsurance, and deductibles that are not covered by the original Medicare. As with Medicare Advantage, there are different levels of coverage for different Medigap plans. However, the Medicare Supplement Insurance plan does not include coverage for any additional services such as dental or vision, though some insurers will offer bundles that include additional policies that cover some of these costs.
Stand alone Dental Insurance
There are a multitude of health plans available by private companies for seniors that include varying levels of dental insurance. When choosing a plan, it is important to read the details carefully as there are large variances in monthly premiums, annual maximum benefits, copays, coinsurance, deductibles, and services covered. Make sure the plan you choose offers an adequate dental plan that will cover your potential dental needs and be aware that some plans require patients to remain within a specific network of medical or dental providers.