When it comes to protecting your overall health, dental care needs to be a priority. This is because the health of your teeth, gums and mouth can have a large impact on your cardiovascular system, your immune system and more. Failing to properly address oral health concerns in a timely manner can lead to pain and difficulty chewing, but it can also lead to serious infections and bone decay. As a result, seniors and other Medicare insurance recipients are encouraged to seek out regular dental care as a means of preventing disease and promoting overall health and wellness.
Does Medicare Cover Dental Care?
While Original Medicare coverage provides for a number of outpatient treatments under Part B, it does not provide a benefit for dental care. Likewise, Medicare Part A will usually pay for inpatient care in a hospital and temporary care in a skilled nursing facility subsequent to a medical condition or rehabilitation need, but it does not implicitly provide for dental care. An exception may be made in cases where dental care is considered a vital part of the rehabilitation treatment being received, but this type of care will not usually be included without paperwork and approval from your plan provider.
Does Medicare Advantage Cover Dental Care?
The good news is that, while Original Medicare coverage does not provide benefits for dental care, Part C Medicare Advantage plans usually do offer a benefit for checkups, screenings, fillings and other routine dental care needs. Medicare Advantage plans are required to include the same benefits as Part A and Part B, but many include additional coverage, including dental services.
If you’re enrolled in a Medicare Advantage plan, it’s a good idea to study your benefits to understand the difference between a covered expense and a reimbursed expense. Covered expenses will be provided for at the time of service or billing, but in cases of reimbursement, you will need to pay for the cost of the treatment up front to be reimbursed later. This distinction is important to understand because it can save you frustration later if you thought something was covered when it wasn’t and the payment has already been made by you.
The Costs Associated With Dental Care and Medicare Advantage
Another important distinction to make when considering Medicare Advantage plans for dental care is the potential for additional costs in premiums or deductible limitations for specific or advanced treatments. In some cases, even though dental care may be covered, a specific deductible amount must be reached before dental benefits begin to apply for orthodontic surgery. Like with most private insurance plans, Medicare Advantage plans may also offer full or majority coverage for routine dental care like cleanings and fillings, leaving recipients to cover more costly procedures like implants, root canals, bridges and dentures.
The way to be sure you’re covered is to review your plan’s coverage options during each renewal period and discuss your needs with your plan manager and dentist. With age, it may be easier to predict the need for future dental care needs based on your dental history, allowing you to plan ahead to have affordable coverage in place before care becomes necessary.
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