Generally, Original Medicare does not include dental coverage. This means you’d have to cover the cost for routine services such as cleanings, dental exams, and tooth extractions out of pocket. Original Medicare also does not cover the cost of dental supplies like retainers, dentures, or orthodontic equipment.
However, some Medicare Part C (Medicare Advantage) plans may include coverage for dental work.
Original Medicare
While Medicare Part A and Part B do not generally cover dental work, there are certain exceptions. For example, if you need dental care as a result of an illness or injury that requires a stay at the hospital, Medicare may cover your treatment. An example is if you had a fall and you fractured your jaw, Medicare will cover the surgery costs to rebuild your jaw and fix damaged teeth. Medicare may also cover certain complicated dental procedures that are performed in a hospital. The procedures can either be covered by Part A or Part B depending on whether you are an inpatient or outpatient. Original Medicare may also provide coverage for dental work as a result of oral cancer or another covered health condition.
If you need a tooth extraction that is deemed as medically necessary before radiation therapy, heart surgery, or other covered procedures, Medicare may also pay for it.
Medicare Advantage
Medicare Advantage plans are sold by approved private insurance companies. They can serve as an alternative to Original Medicare as they combine the coverage from Medicare Part A and Part B. However, many Medicare Advantage plans cover services that Original Medicare does not cover, such as prescription drugs, dental, vision, and hearing services. If you are enrolled in a Medicare Advantage plan that covers dental services, you’ll need to ensure that your dentist is within the network in order to receive coverage for dental work.
It is also important to note that not all Medicare Advantage plans cover dental care. Every plan is different and will always vary, so comparing the plans that are available to you in your area are very important. However, some of the services that could be covered include:
- Cleanings
- X-rays
- Oral exams
- Extractions
- Dentures
- Fillings
- Root canal treatment
- Treatments for gum disease
- Diagnostic services
At Game Changing Benefits, we can help you find a plan that provides you with the coverage you need. Give us a call today to find out more information about Medicare Advantage plans and getting the dental coverage you need.