Medicare offers a variety of dental plans to choose from. The best Medicare dental plan for you will depend on your needs and budget. In this blog post, we will discuss the different types of dental coverage that are available through Medicare, as well as the benefits and drawbacks of each plan. We will also provide a list of the best Medicare dental plans for 2024!
Are Dental Plans Included with Medicare
In general, dental plans are not included with Medicare.
Medicare is comprised of 2 parts. Part A is hospital insurance, which covers inpatient care in hospitals, skilled nursing facility care, hospice care, and some home health care. Medicare Part B is medical insurance, and it covers services from healthcare providers, outpatient care, durable medical equipment, and some home health care.
Medicare Parts A and B also are known as Original Medicare. Original Medicare doesn’t cover most dental care. For example, it doesn’t cover cleanings, fillings, tooth extractions, dentures, or dental devices.
Medicare Advantage Dental Plans
Medicare Advantage plans are a bundled alternative to Original Medicare. These plans provide your Medicare Part A and B benefits, and most also offer Medicare Part D benefits (prescription drug coverage).
Most Medicare Advantage plans also offer benefits that Medicare doesn’t, including dental care. This varies by plan, so it’s essential to review each plan’s benefits carefully before deciding which plan to join.
According to the Kaiser Family Foundation, 92% of Medicare Advantage plans offer dental benefits, but these benefits range from cleanings only to more comprehensive coverage. In addition to ensuring potential plans have dental coverage, look into what that coverage is before selecting a plan.
Dental Coverage Through A and B
In general, Original Medicare will not pay for routine dental care. This includes cleanings, fillings, extractions, and dentures.
Medicare Part A will pay for certain dental services that you get in a hospital. For example, if you’re in an accident and need oral surgery in a hospital, Medicare will cover the dental care. Medicare Part A also will cover complicated dental procedures that require hospitalization.
Medicare also may pay for oral exams, but not treatment, before a kidney transplant or a heart valve replacement.
When You Have Medicare?
How do you pay for dental care if you have Original Medicare with or without a Medicare Supplement? One option is to buy a dental insurance plan. These plans are sold by private insurance companies.
With these plans, you pay a monthly premium. Dental insurance plans vary, but in general, they cover:
- Preventive care: This includes exams, regular cleanings and x-rays, fluoride treatments, and sealants.
- Basic restorative care: This includes fillings, non-routine x-rays, and simple extractions.
- Major restorative care: This includes bridges, crowns, dentures, and more complicated extractions.
Implants may or may not be covered depending on the plan. Dental plans also typically have:
- A deductible: This is the amount you pay for covered services before your insurance plan starts to pay.
- Copays: This is a fixed amount you pay for a service. For example, you might pay $20 for an office visit.
- Coinsurance: This is a percentage you pay for a service. You might pay 20% of the cost of a filling.
- Plan limits: This is the most your plan will pay in dental benefits annually.
You can find dental insurance plans by contacting dental insurance companies directly. You may also be able to enroll through your state’s Health Insurance Marketplace.
Another option for dental care is purchasing a dental savings plan, which also may be called a dental discount plan. With these plans, you pay an annual membership fee. You receive a membership card to present to participating dentists for a discount on their services.
These plans aren’t insurance, so there aren’t any deductibles or copays. You receive the discount at the time of service, and there isn’t a limit on how often you use the discount.
Which Plan is Best For You?
Dental care is essential for good health. Which plan is best? If you have Original Medicare with or without a Medigap policy, a dental insurance or discount plan can help you with dental costs. If you’re looking for an all-in-one solution, a Medicare Advantage plan with dental coverage might be a good fit.
Review your options carefully, and if you’re uncertain, contact your local State Health Insurance Assistance Program (SHIP). These programs offer free, unbiased advice on Medicare and related plans. We also would be happy to help you with any additional questions you may have.