Medicare Dental Coverage

Dental Coverage for Medicare recipients is extremely limited. For people who have had dental insurance through their employer the shock of what Medicare doesn't cover comes as a big surprise.

If you now have dental coverage through work do yourself a huge favor and go to the dentist NOW. Explain to your dentist that retirement is around the corner and you want to get any work you might need in the near future taken care of before you retire. Once Medicare takes over, very little of your dental care will be covered.

The lack of dental coverage in Medicare stems from the time when Original Medicare was established. During the 1960's the importance of dental care was not completely understood. Dental insurance was extremely rare and most dentists earned a living wage but were not considered "medical" professionals. The introduction of HMO plans in the late 70's and 80's paralleled great advances in dentistry. By 2000 dental insurance plans had become fairly common. However, throughout this entire period the rules and regulations related to dentistry under Original Medicare remained largely unchanged. Dental coverage under Medicare became available only in 2003 under Medicare Part C, Advantage Plans. Certain private insurers were given the opportunity to offer dental coverage as part of their Advantage Medicare coverage. Individuals with Original Medicare are also able to buy separate private dental plans called Delta Dental Plans to cover their needs.

Medicare does Cover Some Dental Services

The easiest way to think about what Medicare will cover is to ask the question: Is dental care necessary for some other health reason. For example, Medicare will pay for examinations and extractions in preparation for radiation treatments, heart surgery or kidney transplant cases. This is because infected teeth can lead to greater risks of infection related to the surgery. Hospital stays are generally covered if a complicated oral surgery requires hospitalization. If your teeth are severely damaged due to a tumor or fracture of the jaw or skull some or all of the dental services may be covered.

Medicare Savvy Dentists are a Must

Dentists and their office staff generally are not Medicare literate. This is because Medicare does not cover most dental services. If you have Original Medicare and need expensive dental work it is very important to visit a dentist that is familiar with the rules and regulations of Medicare. It might be possible that your particular set of circumstances may qualify you for coverage. Another alternative is to switch to a Medicare Advantage Plan that includes dental coverage. Make sure to inquire about any waiting periods that might apply before your dental is covered.

Auntie Lou says, "Bah, eating is over rated."