A Medicare dentist and hygienist administering senior dental services

What Senior Dental Services Are Covered by Medicare?

For seniors, routine dental care is essential to overall health and wellbeing. Many health problems can be diagnosed early on by your dentist, which prevents unnecessary health risks and illnesses. As we age, issues like cavities, tooth loss, and gum disease can become more serious and have a bigger impact on our daily lives, affecting our abilities to take in enough nutrients and even our moods. Senior dental services such as routine dental visits, cleanings, cavity fillings, bridges, crowns, and x-rays are typically not included in Medicare Part A and Part B. This may come as a surprise since, as we know, dental health is a major player in overall health, particularly in seniors. It is important to understand what senior dental services are covered by Medicare and what services are not covered. 

4 Senior Dental Services Covered by Medicare

There are a few exceptions for which Medicare Parts A and B will cover dental care. Those exceptions are as follows:

  1. Jaw Injuries – If you experience an injury to your jaw, Medicare will cover reconstruction services. 
  2. Emergency Dental Procedures – When you need to undergo any emergency dental procedures, Medicare will cover those services.
  3. Hospital Stays After Dental Procedures – If you have a dental procedure that requires you to stay at the hospital, Medicare will cover it under Part A and B.
  4. Preliminary Dental Exams – Prior to a medical procedure like a kidney or heart transplant, patients need to undergo a dental exam prior to the procedure. Medicare does cover that dental exam.         

How Seniors Can Get Coverage for Routine Dental Care

Although Medicare Parts A and B typically do not cover routine senior dental care services, there are options to expand your Medicare coverage to ensure that your elderly dental care is covered. The two most commonly used options available to participants of Medicare Parts A and B who want to ensure they receive the proper dental care without tremendous out-of-pocket expense are:

  1. Medicare Advantage – Also known as Medicare Part C, Medicare Advantage can include many routine dental services such as exams, cleanings, fillings, and more. You may find that enrolling in Medicare Advantage/Medicare Part C is a good option for maintaining your dental health. 
  2. Separate Dental Insurance – If Medicare Advantage/Medicare Part C is not right for you, you may consider enrolling in a separate dental insurance program. If you decide to enroll in a non-Medicare dental insurance program, you will want to be sure your plan covers the services you need the most and is not a significant financial burden to you.          

Seniors who see a Medicare dentist, or who are enrolled in private dental plans that cover the majority of their health care needs, are well-positioned to avoid serious medical problems that can begin with poor oral health. The importance of seeing a Medicare dentist, or switching dentists to one who provides senior dental services. cannot be overstated. Oral health is intricately connected with overall health and vitality, after all, your mouth is part of your body, isn’t it? 

Given the fact that oral care is such an important part of our health, it is difficult to understand why Medicare dentists and senior dental services are not automatically covered in Medicare Parts A and B. When Congress established what would and would not be covered under the Medicare programs, it was routinely decided that dental care would not be covered. For some reason, vision and dental have remained on the fringes of health care and are typically only covered by specialized, add-on plans.

Seniors: Don’t Neglect Your Dental Health

If you have not been receiving proper dental care due to a lack of coverage in your Medicare Part A or B plan, it is time to make a change. Your dental health as a senior is extremely important. The necessity of routine checkups, exams, and care for issues as they come up, can not be overstated. Fillings, crowns, bridges, dentures, and other dental appliances are very costly. 

Few will be able to afford those costs out of pocket, which is why choosing coverage with Medicare Advantage/Medicare Part C that allows you to visit a Medicare dentist for all of your senior dental care services is an imperative. If Medicare Advantage is not right for you, or the plan you are eligible for does not cover the services you need, you can enroll in a private insurance program.

Private insurance programs that cover routine dental care are widely available. You will be taking on an extra expense, but in the long run, you will save money and avoid serious health problems by keeping up with your dental care. 

When you are choosing a dental plan, you must consider not only your current needs but also your potential future needs. Have an in-depth conversation with your Medicare dentist to find out what potential services and dental appliances you are likely to need in the future. Your dentist can advise you based on your dental history as well as by relying on his/her professional knowledge of dental care for seniors. 

Your new insurance plan should cover things that you will need in the near future. For example, if your dentist determines it likely that you will need dentures in the near future, you will want to be sure that your prospective new plan covers all denture-related expenses. You will also want to compare prices among plans.

If you are navigating the complex world of insurance and looking for senior dental services that are right for you and your budget, contact Cano Health today. We’ll walk you through the process – and help you take optimal care of your oral health.