Whether you’ve had dental insurance through your employer or through a policy you bought on your own, you’ll want to know what happens when you retire or when you get to Medicare age. Will Medicare cover your dental needs?
The short answer is no. When it comes to most dental care and procedures, Medicare offers no coverage. That includes cleanings, fillings, extractions, root canals, and dentures, among other things.
Does Medicare cover anything dental-related?
Although there is no primary coverage of dental care in Medicare, there is some limited insurance through Medicare Part A, which is hospital insurance. Medicare Part A will cover some dental procedures that happen in a hospital stay. For instance, if you’re in a car wreck that damages your jaw and you go to the hospital, Medicare would cover any reconstruction of your jaw.
Medicare may also cover the following types of things:
- A dental exam in a hospital before a kidney transplant or heart valve replacement
- Dental services related to radiation treatment for some jaw-related diseases
- Dental splints and wiring needed after jaw surgery
- Jaw reconstruction if you have surgery to remove a tumor from your face
But if you need a complex dental surgery that has to be done in a hospital, Medicare would cover your hospital stay, but not the dental surgery.
Keep in mind that even if Medicare covers a procedure like the ones listed above, it won’t cover any related dental care that might follow from something that happened in the hospital.
So where should you go for dental coverage?
Medicare Advantage (Part C) plans, which are private health insurance plans, cover everything that Medicare Parts A and B cover, and some of them also offer dental benefits. Many cover routine preventive care, such as cleanings, X-rays, and regular exams, either partially or in full. You may also find coverage for things like extractions, root canals, dentures, crowns, fillings, and treatment for gum disease.
Like other private health insurance plans, Medicare Advantage plans come in a variety of types, including HMO and PPO plans, as well as private fee-for-service (PFFS) plans. And Medicare Advantage plans generally have a monthly premium in addition to the premium for Medicare Part B, which is $134 in 2018.
But there are some disadvantages to Medicare Advantage plans, such as a more limited list of approved doctors and hospitals. So make sure you understand what you’re getting. You will also need to use a dentist in the Medicare Advantage network, so if you have a dentist you like, check to see if they are in the network. Compare costs and benefits for plans in your area before buying. You can search for a plan using Medicare’s Plan Finder.
Otherwise, if you stick with Medicare as your primary insurance, you’ll need to get separate dental insurance or pay for dental care out of pocket. You can check the costs of private plans using a broker site online.