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How To Receive Dental Care On Medicare, Without Overpaying

By Zawn Villines
Medicare does not cover dental care in most situations, but Medicare Advantage does.

Without good dental care, your risk for heart disease and certain other health issues increases. Despite this connection between dental health and overall wellness, original Medicare does not offer dental coverage.

A 2020 Plos One study examining medical and dental costs in the U.S. found that, between 1996 and 2016, medical and dental healthcare expenditures increased across all groups of people studied—with costs rising the most for older adults. Medicare Advantage recipients almost always have access to dental care, so people concerned about affordable dental coverage with Medicare should consider an Advantage plan.

Dental Benefits on Medicare Advantage

Medicare Advantage plans offer private insurance through the Medicare system. Beneficiaries gain similar benefits to those that traditional Medicare offers, but can also get coverage for additional services, such as dental care and prescription drug coverage. In 2020, 97% of all Medicare Advantage beneficiaries had access to some dental coverage, according to the Kaiser Family Foundation.

Choosing the Right Medicare Advantage Plan

Medicare Advantage plans vary greatly, offering a wide range of services. Your premiums, co-pays, and maximum out-of-pocket spending depend on the specific plan you choose. So when you search for a Medicare Advantage plan with dental care, review the plan documents and ask the following questions:

  • What specific dental services does the plan cover?
  • Does the plan cover preventative care?
  • Are there limits on dental spending?
  • Must I hit a deductible before dental coverage kicks in?
  • Do I have to see an in-network provider?
  • Are cosmetic procedures covered?
  • Must I choose only the less expensive option? Or can I choose, for example, an implant instead of a crown?
  • Can I keep my current dentist?
  • Do dentists in locations convenient to me accept this plan?
  • What is the monthly premium? Do the cost savings on dental care offset the premium?

Alternatives for Covering Dental Care on Medicare

Medicare beneficiaries who do not have a Medicare Advantage plan must wait until Medicare Advantage open enrollment to get dental coverage. Between October 15 and December 7, you can switch from original Medicare to Medicare Advantage. From January 1 through March 31, you can switch your Medicare Advantage plan or return to original Medicare.

If your dental needs are not urgent, it may make sense to postpone dental care until you have better coverage. If you have a dental emergency, though, consider asking the dentist if they offer a cash pay discount or payment plans. In some rare cases, when a dental health issue causes or is caused by a physical health issue, original Medicare may cover a portion of the care. For example, original Medicare usually covers certain dental services for hospitalized people.