Understanding Dental Coverage Under Medicare

The lack of routine dental coverage has significant consequences for older adults. Poor oral health can increase the risk of heart disease, diabetes, and respiratory infections.

Dental problems can make it difficult to chew, leading to nutritional challenges, and affect self-esteem and social interactions, contributing to mental health concerns.

Nearly half of Medicare beneficiaries don’t visit the dentist regularly, avoid going for routine exams, cleanings, and X-rays due to fear of dentists or concern about the costs.

Avoiding the dentist for any reason is not wise considering the health implications that can cause.

However, Original Medicare rarely covers any dental services.

Original Medicare may pay for dental services that are medically necessary prior to another Medicare-covered procedure. For example, Medicare might pay for a tooth extraction if it is required before heart Surgery.

It’s also not as expensive as you might think to pay for your own preventative dental care. A semi- annual exam and cleaning can cost as little as $100 to $125 while an annual set of Bitewing X-rays just $50.

In addition, many dental schools often offer low-cost care for more comprehensive services such as fillings, crowns, root canals, extractions, and even dentures. There are also community clinics that will provide reduced cost services on a “sliding scale” based on income.

Many Medicare Advantage Plan HMOs and PPOs include no cost preventive dental and provide 50% to 100% coverage for comprehensive services as well.

As always, if you have any questions regarding Medicare and dental coverage or options, reach out to us at the office, 724-603-3403. You can also email me personally, Sadie@GetYourBestPlan.com.

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