In this MedicareWire blog post we tackle one of the most common questions we get, “does Medicare pay for my dental care?”
Dental Care for Seniors without Insurance
- Yes, some Medicare Advantage plans do offer dental coverage.
- Yes, Medicare does cover oral surgery and treatment associated with medically necessary healthcare, due to another health condition (e.g., cancer).
- No, Original Medicare does not cover dentures, fillings, and routine teeth cleaning.
- Most Medicare beneficiaries are advised to get additional dental coverage and/or enroll in a dental savings plan (DSP) to help reduce their dental care expenses.
The difficult fact is that there’s virtually zero government assistance available for Medicare beneficiaries who need dental care, including those who can’t afford to pay for it. Both Medicare and Medicaid do not offer oral healthcare coverage for seniors. Medicaid, in some states, have provisions that cover extractions of teeth, but completely exclude the most common oral care we all need as we age. There’s literally no help when it comes to replacing missing teeth and dealing with periodontal disease.
What’s the solution?
Traditional Dental Coverage is not the only Option for Seniors
If you don’t have dental insurance coverage through an employer, a Medicare Advantage plan, or a stand-alone plan, and you can’t afford to get one, there’s another good option. It’s the dental savings plan, often called discount dental. It’s not insurance, and it’s not meant to be. It’s a guaranteed discount, typically in the range of 40-60 percent, on all of the common treatments you need.
The following table demonstrates common savings using a popular DSP from Cigna, one of the largest names in healthcare:
|Dental Procedure||ADA Code||Price w/o DSP||Price w/ DSP|
|Four Routine 6 Month Check-Ups||D0120||$192.00||$96.00|
|Two Full Mouth X-Rays||D0210||$256.00||$140.00|
|Two Adult Teeth Cleanings||D1110||$184.00||$108.00|
|Two Bitewing – Single Radiographic Image||D0270||$60.00||$26.00|
|Two Full Upper Dentures||D5110||$3,074.00||$1,556.00|
|Single Crown – Porcelain On High Noble Metal||D2750||$1,065.00||$594.00|
|Tooth Replacement Part Of Permanent Bridge||D6210||$1,053.00||$559.00|
As you can see, the savings are substantial. Plus, unlike dental insurance, there’s no annual or lifetime cap on benefits, no waiting period to use benefits, and no hassle with claims forms. You can see all of the discount dental plans available where you live here.