Everyone would agree that maintaining strong and healthy teeth is important, but without professional, routine dental care, that might be difficult. Proper dental care doesn’t only ensure a pretty smile and a mouth full of teeth to eat whatever you want, it’s also vital for your overall health.
A lack of routine dental care can lead to tooth decay, painful toothaches, gum disease, tooth loss, and even more serious health problems. As we age, these issues become even more important to address. Many seniors who lose teeth or have ill-fitting dentures find they need to cut out certain foods. This can lead to an imbalanced diet and a host of other health complications. Also, high levels of oral bacteria can cause thrush and other serious diseases that affect vital organs like the lungs and heart.
Unfortunately, many seniors miss out on routine dental care services because they aren’t part of their Original Medicare insurance coverage, and they can’t afford to pay out-of-pocket. Because more and more Medicare Advantage (Medicare Part C) plans are offering dental care coverage in their extra benefits packages, you might consider this type of insurance when you qualify for Medicare. Medicare Advantage plans may provide the dental care coverage solution you need.
How do Medicare Advantage plans cover routine dental care?
Medicare Advantage plans are sold to eligible Medicare beneficiaries by private insurance companies affiliated with this federal health care program. All Part C plans are required to include all the benefits covered by Original Medicare Parts A (hospital insurance) and B (medical insurance).
Medicare Advantage plan providers have the option to include additional coverage for prescription drugs, and extra benefits like hearing, vision, and dental care, among others.
Because insurers recognize that routine dental care is a vital part of senior health care, more and more providers are including it in their Part C plans. However, you should ask a provider for details before enrolling.
Not all Part C plans are alike, but here’s a list of dental care benefits most commonly included:
- Oral examinations
- Teeth cleaning
- Dental X-rays
- Diagnostic services
- Fillings and other restorative services
- Root canal procedures
- Gum disease and oral inflammation treatments
- Tooth extractions
- Crowns, bridges, implants, dentures, and/or denture plates
Your plan provider may have annual limits for the services listed above. You should ask for details from your provider if you aren’t sure.
Depending on the type of Medicare Advantage coverage you have, you may be required to use health care providers, medical facilities, and suppliers that are in a set network. Your insurance provider should include a list of network providers in your printed policy and on their official website. If you aren’t certain about these details, you should call your provider and ask a representative for this information.
What dental care does Original Medicare cover?
Original Medicare doesn’t cover routine dental care services, but it may cover the following:
- Oral exams in the hospital before kidney transplant or heart valve replacement
- Certain dental services you may need for radiation treatment for certain illnesses
- Jaw reconstruction surgery or surgery to treat jaw or face fractures
- Inpatient observation during a dental procedure if you have a life-threatening condition.
These services are generally covered by Original Medicare Part A because they are inpatient hospital services. Medicare Part A covers 100 percent of the coinsurance costs for days 1-60 of your hospitalization. You are responsible for the Part A deductible for the current benefit period.