Does Medicare Cover Dental?

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Contributor, Benzinga
Updated: November 9, 2021

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For most seniors, Medicare is the only healthcare option. Medicare covers everything from hospitalization to doctor’s visits, prescription medications and hospice care — but it doesn’t cover dental. The good news is there are options.

Medicare Part B, medical services, doesn’t cover dental. Vision or hearing, either. Medicare Part A does cover certain medically related dental procedures performed in a hospital, like oral surgery. But, basic Medicare doesn’t cover dental services like dentures, fillings, cleanings, extractions and other basic dental procedures.

What is Medicare?

Medicare is a health insurance option that is available for U.S. citizens the age of 65 or older as well as younger people with select illnesses and disabilities. This federal program is in place to help people pay for their medical expenses. The  multiple “parts” of Medicare coverage, Part A, Part B, Part C and Part D, are all different types of Medicare plans, and each part covers a different aspect of your healthcare costs.

Through the years, Medicare has expanded to cover not just seniors but people with disabilities and chronic illnesses. Social Security Disability Insurance (SSDI) recipients can now qualify for enrollment in Medicare as well. In fact, after 2 years on disability they’re automatically enrolled and receive most of the same benefits as seniors. Medicare now covers individuals with chronic illnesses like end stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s Disease.

You qualify for Medicare when you turn 65. Your initial enrollment period begins 3 months before your 65th birthday and ends 3 months after (7 months in all). All you need to qualify is that you’ve worked and paid taxes for 10 years or more (or you and your spouse have a combined 10 years), and that you’re an American citizen or permanent resident. Medicare is available in all 50 states and the District of Columbia, as well as U.S. territories like Puerto Rico, Guam and the Virgin Islands.

There are 4 basic parts to Medicare:

  • Part A. Hospitalization: Part A covers hospitalization, in-facility treatments, hospice and home care.
  • Part B. Medical services:  Part B covers doctor’s visits, ambulance services and medical equipment like wheelchairs and sleep-apnea devices, as well as mental health issues, both inpatient and out.
  • Part D. Prescription medication: Part D covers most generic prescription drugs. It’s used as a stand-alone plan or combined with others.

These 3 parts cover most coverage needs, but none include dental. That’s where the 4th part, Part C, comes in.

Types of Medicare Advantage Plans

  • Health Maintenance Organization (HMO) Plans  
  • Preferred Provider Organization (PPO) Plans
  • Private Fee-for-Service (PFFS) Plans
  • Special Needs Plans (SNPs)

Like any insurance policy, Medicare Advantage has premiums, deductibles and copays. Some plans offer out-of-network coverage at a higher cost. Once you enroll in a Medicare Advantage plan, you’ll no longer use regular Medicare.

What is Medicare Part C?

Also known as a Medicare Advantage plan, Part C was not part of Medicare when it was established in 1965. Part C was created not as a supplement, like Medigap, but instead as an all-inclusive, bundled plan encompassing parts A, B and D. In short, it picks up where regular Medicare leaves off. 

Medicare Part C is sold by private insurance companies and not only includes parts A, B and D, but adds to it the missing components of vision, hearing and dental. Because Medicare Part C is sold by private insurance companies, prices vary from company to company, state to state.

Medicare Open Enrollment 2021

The Medicare Open Enrollment period occurs every year from October 15 to December 7. Medicare Advantage plan Open Enrollment occurs each year from January 1 to March 31. During this time, you are able to switch from 1 Medicare Advantage plan to another or you can switch from a Medicare Advantage plan back to Original Medicare. During this period, you are also able to join a Medicare drug plan if you are already enrolled in an Original Medicare plan or switch from one drug plan to another.       

Best Medicare Alternatives for Dental

Does Medicare cover dental? Unfortunately, Original Medicare does not offer dental benefits. This lack of coverage can be frustrating, as your oral health is an essential part of your overall well being. While Original Medicare does not cover dental services and you are able to get dental coverage with a Part C plan, you do have additional options to find dental care. 

  • UnitedHealthcare Dental
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  • Ameritas Dental Insurance
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  • Careington Dental
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  • Guardian Dental Insurance
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  • Renaissance Dental Insurance
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Dental Savings Plans

A dental savings plan, also known as a discount plan, is an affordable alternative to regular dental insurance through your state or local health departments offered to individuals and families. You don’t have to pay copays or deductibles and there is usually no annual maximum for how much you can save. The dentist you see will charge a flat fee for the service at a discounted price.   

Private Dental Insurance

You can purchase a stand-alone dental insurance plan from a private insurance company. This insurance plan is similar to any other insurance plan. You pay a monthly premium in exchange for coverage, and in return, your insurance company covers a portion of your care costs. Most dental insurance plans require you to use dentists within the network. Some insurance companies only offer dental coverage when you purchase other coverage such as vision or hearing.

Prepaid Dental Plans

Prepaid dental plans are usually offered to groups, such as an employer or union organization. With a prepaid dental plan, you are responsible for paying the copayment while your insurance provider pays the dentist a fixed amount every month for the coverage. Dental services such as oral evaluations, routine exams, cleanings and x-rays and other diagnostic and preventative services are covered. Some procedures such as fillings and root canals are not covered by prepaid dental plans.   

Benzinga Dental Insurance Reviews

Now that you understand the options that you can use to get dental insurance when you are on Medicare, let’s take a look at a few of our favorite dental coverage providers. 

DentalPlans.com
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Best for Dental Savings Plan: DentalPlans.com

If a traditional dental insurance plan is outside of your budget, you may want to consider comparing dental savings plans through DentalPlans.com.

DentalPlans.com doesn’t only help you locate and compare savings plans valid in your area — the website can also help you locate dental service providers accepting select plans.

This feature makes it easy to both find an affordable dental savings plan and locate a dentist who you can receive treatment from.

Check out the full DentalPlans.com review here. 

DentalInsurance.com
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  • Fast dental coverage
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Best for Comparing Quotes: DentalInsurance.com

If you need to find dental insurance quickly, you might not have time to individually request a quote from multiple dental insurance providers operating in your area.

DentalInsurance.com makes it easy to compare and explore a comprehensive list of options in just a few minutes.

Enter your zip code and some personal information about your date of birth to instantly begin viewing plan costs, coverages and options where you live. 

Check out the full DentalInsurance.com review here.

Smart Health Dental
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Best for Personal Plan Assistance: Smart Health Dental

If you aren’t sure which type of dental coverage is right for you, you may want to first seek assistance from Smart Health Dental.

In addition to providing you with a variety of plan options, Smart Health Dental also employs a full team of customer service professionals who can assist you in comparing plans and signing onto your coverage.

Smart Health Dental’s network includes over 200,000 dental professionals, and it offers everything from savings plans to insurance options. 

Check out the full Smart Health Dental review here.

Physicians Mutual Health
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Best for Comprehensive Coverage: Physicians Mutual

Physicians Mutual is a dental insurance provider offering a selection of traditional dental insurance options.

The company’s most popular plan choice, the Preferred Plus plan, includes coverage for more than 100 basic dental procedures and more than 200 major services.

This plan is available for less than $50 a month for seniors in most areas, and more affordable plans are also available. 

Humana Medicare Advantage
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Best for Affordable Insurance Coverage: Humana

If you need insurance but you’re working on a limited budget, you may want to consider Humana’s affordable dental coverage.

Preventive plans from Humana are available for men and women over the age of 55 for less than $19 a month, which is significantly more affordable than competing insurance providers.

Deductibles are also as low as $50 for individuals and $150 for families. 

Check out the full Humana review here.

How to Compare Medicare Plans

You'll need to consider a number of factors when you select a Medicare Advantage plan, including the following. 

  • Cost: Be aware pf what you’ll pay, meaning deductibles, copayments, annual maximums, drug costs and other out-of-pocket costs. You’ll want to make sure that the plan you're considering fits what you can handle financially.   
  • Provider choice: Each plan has its own network of healthcare providers. If you already have a certain doctor or dentist that you go to, you can try and find a plan that allows you to go to that particular provider. If you don’t, you’ll still want to make sure that the network has providers available that are convenient for you in your area. 
  • Benefits offered: Certain plans offer different benefits such as dental, vision or prescriptions. When comparing plans, you’ll want to choose a plan that offers the benefits you need or want. If dental benefits are very important to you, be sure that your Medicare plan covers these treatments. 
  • Star rating: The Medicare Plan Finder offers star rating resources. This resource gives an overall star rating that takes into consideration the plan’s quality as well as performance regarding the services offered. This resource is similar to reading reviews on Google and allows you to see people’s opinions of that particular plan before choosing it.   
  • Easy Medicare
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  • WellCare Medicare
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  • Blue Cross Blue Shield Medicare Advantage
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What’s the Best Dental Coverage for You?

If you’re on Medicare and need a dental plan but parts A and B don’t cover it, there are several options. It all depends on your personal situation. Maybe you’d like the all-encompassing coverage of a Medicare Advantage plan. Perhaps that’s more than you need.

If all you’re looking for is straight dental coverage, you can choose among options like a dental savings plan, prepaid dental like an HMO or even straight dental insurance like a PPO. Even if you’re on Medicare, you may still be able to afford dental insurance coverage because dental procedures are typically less expensive than medical ones. 

Frequently Asked Questions

Questions & Answers

Q
Do Medicare Parts A and B include dental coverage?
A

Regular Medicare, Parts A and B, do not include dental coverage. Part A covers hospitalization while Part B is for medical services, but not dental. One exception in Part A, however, is if a dental emergency occurs inside a hospital, like oral surgery, then it’s covered. If the emergency involves a normal dental procedure like simple tooth extraction, that’s not covered.

 

Other than that, Medicare Parts A and B do not cover dental. Supplemental plans like Medigap don’t include coverage for dental, either. For dental coverage, you’ll need to enroll in a private plan like Medicare Part C, or get stand-alone coverage.

Q
Is there a dental plan for Medicare patients?
A

Dental plans for Medicare come in the form of Part C coverage. Medicare Advantage plans include dental coverage, everything from check-ups to fillings, extractions and dentures. While Part C is not actually included in Medicare, it’s tailor-made for Medicare recipients.

 

If all you need is dental and not vision or hearing, then a Medicare Advantage plan may not be the coverage you’re looking for. Consider a stand-alone plan like a dental PPO or a dental savings plan. Paying for a Part C plan when all you need is dental may not make good financial sense. Options for dental coverage in place of a Medicare Advantage plan include:

 

  • Dental savings plans
  • Dental insurance
  • Prepaid dental plans

 

Because dental expenses are much lower than medical, dental insurance is often affordable to Medicare recipients.

Dental Insurance Methodology

To determine the best dental insurance providers, we pored through all United States carriers. We winnowed the list by only including companies that have a wide coverage area and product offering. To further break down the list to the true best dental insurance providers, we gave weight to carriers that offer discounts, are available in all states and have multiple payment plan options.

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