In most cases, braces and other orthodontic care are not covered by Medicare. However, if an accident or disease requires a medically necessaryServices or supplies that are needed for the diagnosis or treatment of your medical condition and meet accepted standards of medical practice.... restoration procedure by an orthodontist, Medicare will cover it. Read on to learn more about how Medicare covers braces.
Key Takeaways
- Dental braces are used to align a person’s teeth and jaw so they are comfortable and aesthetically pleasant.
- Medicare does not cover dental procedures unless it is required due to a related medical condition.
- The cost for braces can vary between $4,800 to $7,135 over the course of one to two years of treatment.
- Some Medicare Advantage plansMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B).... offer have dental care as part of their expanded services.
- MedigapMedicare Supplements are additional insurance policies that Medicare beneficiaries can purchase to cover the gaps in their Original Medicare (Medicare Part A and Medicare Part B) health insurance coverage.... policies will help with the costs of Medicare-approved services.
What Are Braces?
Dental braces are wire devices made of stainless steel alloys used to correct overbites and crowded teeth. Braces are most often used during adolescence but can be beneficial to adults as well for cosmetic or functional corrections. Dental braces help people to achieve a straight smile and bite by aligning their jaws and teeth over a period of two or more years.1Mayoclinic.org, “Dental braces“, Accessed October 29, 2021
How Does Medicare Cover Braces?
In the event of an emergency or medical condition that requires a hospital stay, Medicare Part AMedicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care.... may cover the inpatient hospital costs even if the costs related directly to the orthodontic procedure aren’t covered. However, standard orthodontic braces are not covered by Medicare Part A and Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare.... 2Medicare.gov, “Dental Services“, Accessed November 8, 2021
How Much Do Braces Cost?
The cost of braces and other orthodontic treatments varies from one area to the next. The American Dental Association estimates the cost of braces to be $4,800 to $7,135 over the course of the treatment. These costs are not only for the initial installation of the braces, but also the one to two years of follow-up visits, cleanings, and adjustments.3smileprep.com, ”Cost of Adult Braces in California”, Accessed November 8, 2021
Medicare Advantage
Although Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage.... limits the circumstances that cover orthodontic care, many Medicare Advantage plans include dental insurance benefits. Because Medicare Advantage plans are offered by private insurance companies, the packages available through these plans differ. Even though they may offer coverage for routine dental care, this may not include specialist care like braces or other orthodontic care. Check the list of benefits a plan offers to understand coverage, cost-sharing, and coverage limits.4Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed October 29, 2021
Summary
Unfortunately, Original Medicare (Part A and Part B) will not cover the costs of your braces or other orthodontic devices. If you need coverage for braces to get the perfect smile, you should check the Medicare Advantage plans in your area. Many Medicare Advantage plans cover dental care services and orthodontics as part of their expanded dental services.
Citations
- 1Mayoclinic.org, “Dental braces“, Accessed October 29, 2021
- 2Medicare.gov, “Dental Services“, Accessed November 8, 2021
- 3smileprep.com, ”Cost of Adult Braces in California”, Accessed November 8, 2021
- 4Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed October 29, 2021