Does Medicare cover Dental Care?

Medicare Enrollment Period

Does Medicare Cover Dental Care?

Does Medicare cover Dental Care? If you are new to selling Medicare you may be shocked to learn that Medicare does not cover most dental care such as cleanings, fillings, tooth extractions, or dentures. Original Medicare has two parts: Medicare Part A (hospital) and Part B (doctors and outpatient care). Part A may cover dental work if your senior clients suffer a traumatic injury that affects their jaw, teeth, or mouth and has to be hospitalized, but otherwise, Medicare does NOT cover dental care.

What type of dental coverage is available for seniors on Medicare?

Oral care is a major issue for many seniors. The Centers for Disease Control and Prevention (CDC) report that 1 in 5 adults over the age of 65 have untreated tooth decay. An estimated 68% of seniors have gum disease and nearly 1 in 5 of adults aged 65 or older have lost all of their teeth. Older Americans with the poorest oral health tend to be those who are economically disadvantaged and lack insurance. If you are a Medicare agent and your senior clients want to keep up to date on regular checkups and preventative procedures, without breaking the bank, here are some options:

 

1. Choose a Medicare Advantage Plan

Only Medicare Advantage Plans (Part C) offer dental coverage. However, it is important to note that not all of them do. The dental coverage offered by Medicare Advantage Plans is typically for routine services such as Teeth Cleaning, Routine X-rays, Extractions, or Fillings. In addition to basic dental care, some Medicare Advantage Plans also cover extra benefits like vision and hearing. You’ll want to confirm your client’s needs and the plan details before enrolling them.

 

2. Choose a Standalone Dental Insurance Plan

There are many affordable dental plans – HMO, PPO, Indemnity, and Discount Plans – available from private insurance companies. Some plans like the UCT Dental Indemnity Plan, even combine Dental, Vision, and Hearing into a single policy with no network. This means your clients can use any provider they want.  You are responsible for a monthly premium, deductible or copay with these plans, however, that cost is offset by lower out-of-pocket fees.

 

3. How else can seniors get low-cost dental care?

There are other ways of getting Free or reduced-Cost dental care without insurance. Here are some suggestions you can give to your clients on a tight budget.

  • Check with your state’s Department of Health for programs in your client’s area that offer free or reduced-cost dental care. For example, here is a list of Low-Cost Dental Options from Texas’s Dept of Health.
  • According to HHS (health and human services) accredited Dental Schools are a good source of quality, low-cost dental treatment.
  • Before turning 65 your clients can open a Health Savings Account (HSA) and use what has been saved to help pay for expenses, including eligible dental care. However, once they enroll in Medicare they can no longer contribute to the fund.

 

Agents

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