When seniors discuss Medicare coverage, it’s often questioned how much of your medical needs Medicare actually covers. Medicare Part A covers all inpatient hospital needs, Medicare Part B covers all outpatient needs, and Medicare Part D covers prescription drug needs. Unfortunately, there are some gaps in Medicare coverage. Among these gaps lies dental care. While there are some situations in which Medicare may cover some dental services, it typically does not cover most services.
Medicare and Dental Service
Routine dental services are not covered by Medicare. Medicare considers exams, cleanings, crowns, bridges, fillings, or other similar procedures that dentists provide at their offices, as dental services. However, Medicare may choose to cover dental services in the event of a medical emergency. Emergencies that Medicare might cover include situations such as one where you might need to get jaw reconstruction surgery from an accident. Medicare may also cover other scenarios of the like, in which doctors order extensive medical procedures to prevent larger health conditions stemming from the tooth or gum damage.
If you have a large upcoming surgery, Medicare will cover any dental exams that a doctor or surgeon might need before the surgery. Because these exams foster safety and prevent any major medical issues, you will not have to pay extra fees for these checks.
However, as mentioned, Medicare does not cover routine cleanings, fillings, crowns, or other dental services. For this, you must decide to get an additional dental plan. If you don’t want to get an additional plan, you have some other options.
Medicare PACE Dental Coverage
Some eligible seniors can receive dental coverage under the Medicare PACE program. To qualify for this program, you must be dual-eligible. This means you must qualify for both Medicare and Medicaid. Not all seniors meet these qualifications. If you, however, are eligible for the program, you would also receive additional benefits included in the program such as physical therapy, adult day care, and more. This often proves to be one of the most economic options for seniors looking for covered dental care.
Medicare Advantage Dental Coverage
If you do not qualify for the Medicare PACE program, enrolling in a Medicare Advantage (Medicare Part C) plan might be an option. Medicare Advantage provides the exact same benefits as Original Medicare Parts A & B, but function as a private insurance plan. Depending on the plan you choose, you might get some additional benefits, and among these benefits, is dental care. Medicare Advantage might cover all dental services such as routine cleanings, X-rays, exams, and fillings.
It is important to remember that there are some downfalls to enrolling in a Medicare Advantage plan. While there are many benefits, they can often require you to see a certain provider within your plan’s network. This limits the number of providers that can provide you with the services you need, and your doctor of choice might be out-of-network.
In addition, not all Medicare Advantage plans offer these dental benefits. Some plans can offer more than others. It depends on many different factors that you can discuss with your agent. It is important to consider your current and future dental needs when considering one of these plans. You also must keep your ideal monthly budget in mind.
Senior Dental Coverage
While all of these options may fill you with uncertainty and concern, you can feel safe knowing that the right plan for you is available. If it is not found in the Medicare PACE program or through Medicare Advantage, you can get a separate Dental, Vision, and Hearing plan.
Adding one of these plans will ensure that you receive all of the services you need for a low monthly cost. You will be able to get routine cleanings, exams, fillings, and more with these plans.
When adding a Dental, Vision, and Hearing plan, you might also want to consider adding a Medicare supplement plan. A Medicare supplement plan will ensure that you do not have to pay any costs out-of-pocket for your Medical needs. With a Dental, Vision, and Hearing plan and a Medicare supplement plan, you will have full coverage for any medical need you might have.
Get a Dental, Vision, and Hearing Plan
If you are ready to take the next step in taking care of your health care needs, we can help. Feel free to get your free Medicare supplement quote online or talk to one of our agents at (800) 310-2550. Once you connect with an agent, they can help you add a Dental, Vision, and Hearing plan to your comprehensive coverage.