Does Medicare cover dentures or dental implants?
- Original Medicare does not cover dentures (false teeth).
- Original Medicare does not cover dental implants unless they are deemed medically necessary due to another serious health issue (e.g., cancer).
- In general, Medicare does not cover any routine dental or oral health services, including cleanings, X-rays, fillings and other restoration work.
- For most Medicare beneficiaries, dental comes out-of-pocket, through a Medicare Advantage plan, or separate insurance.
- For many seniors, the best solution is a Dental Savings Plan.
Why doesn’t Medicare pay for dental?
Study after study have yet to conclusively link poor oral health in seniors to chronic health conditions, such as heart disease, or to serious heath problems, including stroke or heart attacks. Until a clinical study can prove the link between oral health and overall health, Medicare and Medicaid are unlikely to offer routine dental care to seniors and people with disabilities.
What’s the real issue?
Many seniors with Medicare benefits fall into a quandary. They enroll in Medicare (original or an Advantage plan), but fail to get dental coverage. Then, when then need dental work, they realize it’s too late because almost all dental insurance policies have a waiting period for restoration work and oral surgery. Plus, most policies have a ridiculously low life-time and/or annual benefit.
Are Medicare Advantage Plans with Dental worth it?
A few local and national Medicare Advantage plans offer dental coverage as part of their plan. Aetna is a classic example. The healthcare network offers dental in employer group plans, and as a stand alone offering, so bundling it with their premium Part C plans makes sense. However, savvy seniors should note that there’s little or no savings compared with an Advantage plan without dental and individual dental insurance.
What’s the solution?
If you find you’re looking at Medicare Advantage as an option, and you can find a plan with dental at a good price, congratulations. The issue for most people is trying to match an HMO or PPO plan with the doctor(s) they like and the medications they use. It’s really difficult. So, really, dental is just a small bonus to everything else working out.
For a growing number of seniors, the best path is a dental discount plan, also known as a dental savings plan. It’s not insurance. It’s a per-negotiated discount in the range of 40-60% on just about every dental procedure you can imagine. The cost is very modest; around $127 per year for an individual or $169 for you and your spouse. Plus, there’s no waiting, no limits, and no claims forms to deal with, just easy peasy cost savings.
Not convinced? Savings plans are offered by some of the largest name in healthcare, including CVS, Aetna, Cigna, Aon and many more. See all of your options on our Dental Plans and Insurance for Seniors page.