What Medicare plans cover dental?
Our teeth are important. We use them to eat, smile, and communicate. It’s only natural that you want to take care of your teeth as you get older. You’ve worked hard to keep them healthy, after all.
Today, we’re going to look at the different Medicare options and which ones have dental coverage (spoiler alert: it’s not as many as you’d think).
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Medicare Part A
Medicare Part A is your hospital insurance. Because of this, Part A does not cover dental care unless it is deemed a medical emergency.
Medicare Part B
Medicare Part B covers outpatient medical care. And while you would think this would be extended to dental coverage, this is not the case.
Dental coverage is not included in Medicare Part B in most circumstances. Exceptions are rarely made if the dental procedure is part of another covered service.
Medicare Supplement plans
Medicare Supplement, or Medigap, plans supplement Original Medicare. That means they only cover what Parts A & B cover. Since neither of those cover dental, neither do most supplemental plans. However, there does seem to be a trend toward including it in the future.
Some providers, such as Blue Cross Blue Shield of Illinois, are starting to include limited dental options in some plans. When their Plan G Plus plan came out in 2020, it included some routine dental benefits at a higher premium. And while this trend will take off nationwide waits to be seen, it is worth keeping an eye on in the future.
If you're interested in dental coverage and have a Medicare Supplement, just call our office and we'll double check the options in your county.
Medicare Part D
Medicare Part D is a prescription drug plan you can purchase. That means it covers pharmaceuticals. While you might get antibiotics or pain medication because of dental work, the procedure itself is not covered in Part D.
Medicare Advantage (MA)
Medicare Advantage plans offer the most variety of coverage to customers. Part of that variety is dental care coverage. Today, most Medicare Advantage plans offer dental insurance as an incentive to pick their plan.
As of 2021, 94% of Medicare Advantage enrollees in individual plans have access to some dental coverage (KFF study).
MA plan coverage varies by plan, but it exists and is competitive with most major health insurance dental options, as many plans are sold by the same companies.
There is also the option to purchase separate dental insurance, made for those enrolled in Medicare.
Dental plans are often very affordable and can cover up to several thousand dollars of dental care each year.
Learn more: Dental, Vision, Hearing Insurance
What does dental insurance look like in Medicare Advantage plans?
Once you’ve explored the various Medicare options, you will still have to navigate the world of Medicare Advantage.
These plans, which are legally required to offer the same basic coverage as Original Medicare, add things like dental onto plans to make plans more attractive. That means that, while the basic plans might look similar, dental options can vary based on company and location.
We’re going to briefly look at a couple of MA options to show you how much dental coverage can vary from plan to plan.
Option #1 is an HMO offered in Oklahoma. This plan offers $0 copays on preventive dental exams, cleanings, and X-rays.
For non-routine services, such as restorative services, extractions and other specialist procedures, they have a 20%-50% coinsurance with limits and authorization requirements. This means that if you need dentures or other more expensive dental work done, you might end up paying half of the total cost.
Option #2 is a Utah-based PPO. This plan has network requirements. If you are in-network, they cover 100% of preventive care and non-routine services. Outside the network has a 50% coinsurance, and most specialist procedures have a 50% coinsurance, regardless of network.
Option #3 is a five-star plan in greater Washington D.C. region. Its coverage is inconsistent. It covers preventive care under the office visit and its comprehensive copays range from $0-$55 for fillings to $30-$3,600 for oral surgery.
It just proves that each plan is different in Medicare Advantage, regardless of provider or star rating.
It might seem hard to find Medicare coverage with dental options, but it's not impossible. If you are looking for a plan with dental coverage, we are here to help.
Give us a shout and we’ll find the perfect coverage for you, whether it's finding a plan that includes dental coverage or adding on a dental insurance plan to what you already have.
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