Medicare beneficiaries who also receive Medicaid-related services, commonly referred to as dual-eligibles, may have access to certain dental services if their state offers coverage for those procedures. In Kentucky, recipients may need to meet certain income limits and establish an appropriate level-of-care need to qualify as a dual-eligibles.
Two Common Types of Dentures
Dentures, also known as false teeth, can be made from a variety of compounds in full or partial plates that fit the upper or lower parts of the mouth. Removable plates are the most common and affordable option in terms of upfront costs, but they require careful cleaning and cannot be worn overnight. Future repairs or replacements can also increase the total cost associated with these types of dentures.
Dental implants are also common, but they are most costly in the beginning and may not be a viable option for everyone. Implants require certain conditions when it comes to the density and stability of any underlying bone tissue. While they may have an easier adjustment period once in place when compared to removable dentures, patients may still need to spend several months wearing removable dentures if they’re healing from the extractions necessary to prepare for implants.
Evaluating Your Need for Dentures
Illness, injury or existing health conditions may contribute to tooth decay or loss. If you’re experiencing recurring pain, brittle or broken teeth or other uncomfortable symptoms of poor oral health, then partial, full or implanted dentures may be able to bring you some relief.
Dentures can also serve an important role in preserving healthy teeth if you’re missing more than one or two teeth on either side of the upper or lower set. The pressure of your bite can make your remaining teeth shift and loosen, so partial dentures work to help keep them in place and prevent your bite from changing and creating more damage to other teeth.
Bleeding gums can be a sign of periodontal disease, which also contributes to tooth decay and loss. Talk to your oral health care provider about any issues you may have when biting, chewing or cleaning your teeth. They can help you determine if any teeth should be extracted, if you need full or partial dentures or if your bone tissue is strong enough for dental implants.
Coverage for Dental Services in Kentucky
In Kentucky, qualifying adults over the age of 21 may only be eligible to receive routine or emergency dental services through Medicaid. Dentures do not typically qualify under routine or emergency oral care. While Original Medicare does not cover dentures, either, recipients may be able to save on costs by signing up with a Medicare Advantage plan that provides extra dental benefits that Medicare and Medicaid do not provide.
Some Medicare Advantage plans may not be available for dual-eligibles, or insurers may only offer specialty plans that require recipients meet certain eligibility criteria. Premiums for Medicare Advantage plans are not covered by Medicare Savings Programs through Medicaid, but Original Medicare Part A or Part B premiums and related out-of-pocket expenses may be paid for by the recipient’s Medicaid-related benefits. Consider your options carefully and contact your state’s Department of Medicaid Services for specific details.