Does Medicare Cover Dental Implants?
Dental implant procedures are becoming more and more common, even among seniors. Getting a dental implant requires oral surgery to place the titanium post(s) into the bone mass where the root portion of the missing tooth was. Then an extension of the post (an abutment) is installed, and finally, an artificial tooth, or crown, is placed on the abutment.
A dental implant procedure can take up to several months because of the healing process, but the result is a tooth that looks and feels like a real one.
For most people, dental implants improve appearance and speech, and they may make eating easier. For seniors, getting dental implants can help solve some common health problems that happen with age. Dental implants help anchor the remaining teeth and prevent further tooth loss. They can also benefit overall nutrition because food can be chewed properly. Also, missing teeth can lead to the deterioration of the jawbone when it isn’t properly stimulated. Getting implants can help stop deterioration and prevent tooth loss.
How does Medicare cover dental care services?
Original Medicare Parts A and B don’t cover routine dental care services like cleaning, oral exams, fillings, crowns, bridges, dentures, dental plates, or dental implants.
However, Medicare Part A, which is your inpatient hospital insurance, pays for a very limited number of dental services that you receive as an inpatient in a hospital. You may also have coverage for your hospital stay through Part A if you must have an emergency or complicated dental procedure while a hospital inpatient. To be eligible for coverage, the hospital must accept Medicare assignment.
Through Medicare Part A, you pay $0 coinsurance for days 1-60, but you must pay your Part A deductible for the current benefit period before Medicare begins paying its share. The Medicare Part A deductible in 2022 is $1,556.00.
Does Medicare Advantage cover dental care?
Because Medicare Advantage (Medicare Part C) plans are sold by private insurers, providers have the option to include extra benefits in their policies along with the compulsory Medicare Part A and B benefits.
Coverage for routine dental care varies from plan to plan, but the most common benefits included are:
- 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, dental implants, dentures, and denture plates or partials
What you pay for your routine dental care services depends on the type of plan you enroll in. Some Part C providers charge an additional premium for extra benefit packages. There are also plans available that offer annual allowances or rebates to help you pay for these services.
Your Medicare Advantage plan provider may also require that you use dentists, physicians, medical suppliers, and medical facilities that are included in the plan’s network of providers. These restrictions depend on the provider and the type of plan you enroll in.
To ensure that you get coverage for any dental work you plan to have, ask your provider whether you must use network providers, who they are, and if you need a referral from your primary dentist to visit a specialist for the dental implant procedure.