How Could Medicare Dental Coverage Change In 2022
In 2021, a bill was introduced in the House to add dental coverage to Medicare Part B.
Known as the Medicare Dental, Vision, and Hearing Benefit Act, the idea has support from the White House as part of President Biden’s Build Back Better agenda. Specifically, the fiscal year 2022 budget proposal for the U.S. government indicates the intent for “improving access to dental, hearing, and vision coverage in Medicare.”
This is not the first time it has been proposed to offer dental coverage to Medicare beneficiaries, and it’s an important health care issue. About 47% of those on Medicare don’t have dental coverage.
The legislative process will determine if Medicare benefits are expanded in 2022 to include dental. However, there is political incentive because adding dental, vision and hearing is cheaper than other proposed Medicare extensions, such as adding nursing home coverage.
Dental Coverage Under Medicare: Comparison Table
In summary, here are the types of Medicare, what they cover, and if dental coverage is available:
| Type of Medicare | ||
|---|---|---|
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Original Medicare |
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Medicare Advantage |
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Medicare Supplement Insurance |
Costs not covered by Original Medicare |
Does Medicare Part B Cover Any Dental Expenses
Yes, but Medicare Part B only covers dental expenses that are a medically necessary part of another covered service. It does not cover routine dental services, such as cleanings, or other standard procedures like dentures, crowns, or fillings.
In fact, approximately 24 million Americans on Medicare do not have dental insurance that covers these services.1 These services would need to be covered through independent senior dental plans or through a Medicare Advantage plan that includes dental coverage.
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Does Medicare Cover Dental Implants
Does your dentist say you need dental implants? If youre not sure about the details of Medicare dental coverage, we hope you find this overview about Medicare and dental implants useful.
Find affordable Medicare plans in your area
If youre like many Medicare beneficiaries, you might already be enrolled in Original Medicare, Part A and Part B. Original Medicare typically doesnt pay for routine dental services. These generally include routine care, oral exams, cleanings, fillings, extractions, and implants. Original Medicare dental coverage is very limited.
The only dental services that Original Medicare may cover are usually those that are an essential part of a Medicare-covered procedure. For example, Medicare may cover a dental exam that you get prior to a heart valve replacement surgery or kidney transplant, as part of an overall pre-surgery exam. However, when it comes to Part A and Part B, Medicare dental coverage doesnt cover most routine dental care.
What Does Medicare Cover In Dental Services
If you choose a plan that offers dental services, you will likely want to know what Medicare covers under these plans. Coverage from Medicare Advantage plans may include:
- Routine cleaning and examination
This list can vary from plan to plan. Check the plan you choose carefully to know whether it includes the services you need now or may need in the future.
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Does Medicare Supplement Cover Dental Care
Along with medical care, dental care becomes increasingly important as we age. Dental problems can become more pronounced or lead to serious health complications. If you are eligible for Medicare, you may be wondering what dental benefits you may qualify for. Original Medicare Part A and Part B covers many healthcare expenses, but it doesnt cover all of your costs. Many Medicare beneficiaries choose to enroll in supplemental insurance to help cover some of the costs Original Medicare does not. Unfortunately, Medigap policies do not include dental care services.
Just as youre more likely to experience health problems as you age, youre also more likely to experience dental issues as you age. One of the most common issues is simply tooth decay. Decades of use, combined with acidic or sugary foods, start taking a toll. Other common problems include gum disease, receding gums, and even oral cancer. If you are eligible for Medicare, you have options when it comes to dental care coverage.
What Is Medigap Coverage?Medigap coverage is a private insurance policy that you buy in addition to your Medicare coverage. It comes with a monthly premium like other private insurance policies. That premium is in addition to your standard Medicare premiums. The function of a Medigap policy is covering costs that Medicare Part A and Part B dont normally cover, such as:
- Deductibles
- Copayments
Some Medigap policies also provide coverage for emergency medical services while you travel abroad.
Option : Medicare Advantage Plans With Dental Coverage
Dental coverage varies widely by Medicare Advantage plan. In some cases, you have to pay extra to have dental care included in your plan. There could also be options for basic or premium coverage, letting you choose the dental plan that works for you.
Look for plans that offer low-cost or free preventative services. If you need more expensive treatments, pay attention to the plan’s cost-sharing percentage and the cap on how much the plan will cover each year.
AARP: largest network of dentists
Among our picks for the best Medicare Advantage plans, Aetna has the cheapest monthly costs. The company reimburses policyholders for in-network dental coverage, and it provides the option for expanded dental benefits at an additional monthly cost. This can be a great way to manage your expenses if you need significant dental services in the upcoming policy year.
If you’re signing up for a new Medicare Advantage plan, you can choose your dental coverage options during the plan selection process. If you’re already enrolled in Medicare Advantage, talk to your provider about what dental coverage options are available to you, and if there is no add-on coverage available, you may be able to enroll in a standalone dental policy.
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Does Medicare Advantage Provide Dental Benefits
Original Medicare does not provide dental benefits except under extremely limited circumstances. Fortunately, some Medicare Advantage plans come with options for covering basic and major dental services. About 53% of Medicare Advantage beneficiaries had access to preventive and extensive dental benefits such as dental implants in 2019.
What Does Dental Coverage Cost
Generally, the cost of Medicare Advantage plans and dental coverage specifically in cases where theres an extra premium involved vary based on factors like your age and where you live. Some have a $0 monthly premium while others cost more. In eastern Pennsylvania, for example, Medicare Advantage plan premiums range from $0 to $302 a month. In the Los Angeles area, they range from $0 to $397 a month.
Low-cost Medicare Advantage plans that dont include an extra monthly premium for dental coverage typically include basic dental services, such as checkups and cleanings, says Worstell.
The more expensive plans include coverage of more advanced dental services like extractions and dentures and other things more relevant to older patients.
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Does Medicare Cover Vision And Dental
Original Medicare does not cover routine dental or vision care. There are certain circumstances under which Original Medicare may provide some coverage for dental or vision care in an emergency setting or as part of surgery preparation.
However, you may be able to receive routine dental and vision coverage by enrolling in a Medicare Advantage plan that includes dental and vision benefits.
Do Medicare Advantage And Medicare Supplement Plans Cover Dental
Sometimes, Medicare Advantage plans are approved by the federal government and sold by private insurance companies. These plans often offer services not covered by Original Medicare, such as dental, vision and hearing coverage, says Christian Worstell, a North Carolina-based licensed insurance agent. Enrollees might pay an extra premium for these benefits. However, not all Medicare Advantage plans offer dental coverage, so its important to read your plans details carefully.
Medicare Supplement plansalso known as Medigap plansdont directly cover dental, but they pick up some of the out-of-pocket costs like copayments, coinsurance and deductibles, says Worstell. Plus, many insurance companies that sell Medigap plans offer you the option of adding a dental or vision package for an additional premium, he adds. They dont all do that, but a lot of carriers these days are now offering it.
Medicare Advantage plans tend to be the best way to get dental coverage, but you can also buy a separate dental plan offered by a private insurance company, says Worstells.
My advice to all incoming Medicare beneficiaries is to ask yourself, How do I plan to pay for my dental care? Do you have the funds to pay for it out of pocket? If not, you should strongly consider a Medicare Advantage plan or a standalone dental insurance plan from a Medicare carrier or insurance carrier, advises Worstells.
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What Dental Services Are Covered By Medicare Part B
While there’s no coverage for the regular care, treatment, removal, or replacement of teeth, Medicare Part B dental coverage does cover dental services performed by a physician that are an integral part of another covered procedure. Examples include:
- Oral exams in anticipation of a kidney transplant.
- Extractions done in preparation for radiation treatments involving the jaw.
- Reconstruction of the jaw following an accident.
- Outpatient exams required before an oral surgery.
Because none of these cases are preventative or common dental treatments, it would be beneficial for Medicare beneficiaries to invest in a stand-alone dental plan to help subsidize the cost of receiving the regular dental services that are essential to maintaining oral health. Services such as cleanings, fillings, tooth extractions, dentures, dental plates, and regular dentist visits are not covered by Medicare Part B or Part A.
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Does Medicare Cover Dental Health
En español | Original Medicare has no dental plan. It does not cover most routine dental services such as exams, cleanings and X-rays procedures related to dental health, such as fillings, extractions and root canals or dentures and other dental devices.
However, original Medicare can pay some costs associated with emergency or medically necessary dental care.
For example, Medicare Part A, which includes hospital insurance, could cover having teeth pulled in preparation for radiation treatment of jaw cancer, or inpatient care if you need a complicated or emergency dental procedure while in the hospital, such as jaw reconstruction after an accident.
If you rely on Medicare and want coverage for regular oral care, look into Medicare Advantage plans. These policies, offered by private insurance companies, include all original Medicare coverage and often have extra benefits such as dental services .
Another option is Medicare Supplemental Insurance, better known as Medigap. These plans, also sold by private insurers, cover some out-of-pocket costs for Medicare treatment. They do not specifically include extra benefits, but some Medigap providers offer clients options for dental coverage, or discounts on out-of-pocket costs for oral care. If you have Medigap, ask if your provider offers related dental benefits.
Editor’s note: This article was originally published on July 15, 2015. It has been updated with the latest information regarding Medicare coverage in 2020.
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Find Cheap Medicare Plans In Your Area
Original Medicare does not provide comprehensive dental care, and Medicare Part A will only cover select dental services that require hospitalization. For most types of dental care, such as cleanings, X-rays or root canals, you’ll need dental coverage through a Medicare Advantage plan, a standalone dental plan or Medicaid.
Which Medicare Advantage Plans Cover Dentures
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Find A Medicare Advantage Plan That Covers Dental And Vision Care
Medicare Advantage plans can come in a variety of types, such as HMOs or PPOs.
The type of plan you have may affect which dental or vision providers you can visit in your plan network. Before enrolling in a plan, its wise to check the plans network participants to see if your favorite dentist or optometrist accepts the plan.
Compare Medicare Advantage plans in your area
Or call 1-800-557-6059TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!
1 Fugelsten Biniek, J. et al. . Medicare Advantage 2021 Spotlight: First Look. Kaiser Family Foundation. Retrieved from www.kff.org/issue-brief/medicare-advantage-2021-spotlight-first-look.
About the author
Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareAdvantage.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options.
His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.
Christian is a graduate of Shippensburg University with a bachelors degree in journalism. He currently lives in Raleigh, NC.
Where you’ve seen coverage of Christian’s research and reports:
Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE , 24 hours a day/7 days a week or consult www.medicare.gov.
Do Medicare Advantage Plans Cover Dental And Vision
Medicare Advantage plans can offer coverage for dental and vision health items in addition to also offering the same coverage as Original Medicare. Most also include prescription drug coverage as well as other benefits such as hearing health coverage and gym memberships.
Medicare Advantage plans are offered by private insurance companies. The plans available to you depend on where you live. What specific dental and vision items are covered and how much they cost will vary from plan to plan.
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Does Original Medicare Part A And Part B Cover Dental
Original Medicare is composed of Part A, which is hospital insurance, and Part B, medical insurance. The only instance in which Original Medicare might cover any dental work, is if you suffered a traumatic injury that also affected your jaw, teeth, or mouth and had to be hospitalized. Then, Original Medicare may cover some of that dental care. Understanding exactly what your plan would cover is important to know before accidents occur.
Why You Need A Dental Plan For Seniors
As you age, you may be at increased risk for certain dental conditions, according to the American Dental Association. Dental conditions associated with aging include dry mouth, dental caries and periodontitis, a serious gum infection. Physical and cognitive impairments may also make home oral health care difficult for seniors, exacerbating dental problems. You may wish to have a Medicare dental plan to avoid paying out-of-pocket for dental treatment.
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Does Humana Medicare Cover Dental
- Dental coverage is available through most of the Medicare Advantage plans that Humana offers.
- Youre eligible for Humana Medicare Advantage dental coverage if you have original Medicare .
Humana offers dental coverage under many of its Medicare Advantage plans. Read on to learn more about Humana Medicare Advantage plans and the dental benefits they offer.
Find A Unitedhealthcare Medicare Plan With Dental Coverage
Because Original Medicare does not provide dental coverage, Medicare beneficiaries may want to consider joining a UnitedHealthcare Medicare Advantage plan that offers dental coverage.
To learn about the dental coverage included in any UnitedHealthcare Medicare plans that are available in your area, speak with a licensed insurance agent by calling 1-855-580-1854TTY Users: 711 24 hours a day, 7 days a week.
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How Do I Enroll In A Humana Medicare Advantage Plan
To enroll in a Humana Medicare Advantage plan, youll need to find out which plans are available in your area.
You can see what policies are open to you by visiting Humanas website. Enter your ZIP code and select your county to see a list of the Humana Medicare Advantage plans in your area.
To learn more about Humana Medicare Advantage plans, contact a customer service representative at 800-457-4708.
You can also request to meet with a Humana representative by filling out a contact form.
What About Medicare Supplement Plans
Most Medicare Supplement Plans do not include any dental coverage either. So if you are enrolled in Parts A and B with a Medigap plan and Part D coverage for prescription drugs, you likely will not have any routine dental coverage.
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