Dental care is about more than flashing a sparkling smile. The health of your mouth plays a big role in your overall health, but if you're on Medicare, you may have to jump through hoops to get the dental coverage you need.
When you enroll in Medicare, the federal insurance program for U.S. residents 65 and older as well as some younger people with disabilities, you can choose original Medicare or Medicare Advantage, in which you get your Medicare coverage through a plan from a private insurer.
One downside to traditional Medicare, also known as original Medicare, is that it does not cover dental work, except in rare circumstances.
For example, if you needed oral surgery to treat an underlying medical condition like cancer, and the procedure includes some dental work, that would likely be covered. And any dental procedure that's necessary before a Medicare-covered procedure also would be covered, according to the National Council on Aging. For example, a tooth extraction needed before heart surgery would be covered, according to the NCOA.
And Medicare Part A, which is the hospital insurance part of traditional Medicare, will cover the costs of your hospitalization if you get admitted to the hospital for dental surgery even if Medicare doesn't cover the procedure itself, according to Medicare.gov.
But routine cleanings, fillings and dentures? With traditional Medicare, you'll pay out of pocket unless you have other coverage.
Options for seniors looking for dental coverage
If you want to avoid getting hit with big dental bills, you have two main options for getting dental insurance on Medicare:
1. A Medicare Advantage plan that includes dental care. Medicare Advantage, also known as Medicare Part C is an alternative to traditional Medicare that allows you to get your Medicare benefits by buying a plan from a private insurance company. Medicare Advantage plans may cover services original Medicare doesn't, including dental care, according to Medicare.gov. In fact, many Medicare Advantage plans include dental care, according to insurer United Healthcare.
However, it's important to check the details to see what is actually covered. For example, some plans may cover preventive care like cleanings and oral exams but not treatments like fillings, crowns or tooth removal. You'll also want to check the maximum annual payout, which is the most the plan would pay toward your dental care each year, according to Senior65, a licensed health insurance agency that sells Medicare policies. To shop for a plan, work with an independent insurance agent who represents multiple companies and can help you compare plans and understand what is actually covered, Ohman recommends.
2. Traditional Medicare plus a separate dental insurance policy. If you go with traditional Medicare, you'll also need to get a Medigap policy to fill the gaps in coverage. The Medigap policy will pick up copays, deductibles and other costs but won't include dental coverage. So a standalone dental policy can be a great option, especially if you visit the dentist frequently, Ohman says.
You may be able to find a dental policy for as low as $10 a month.
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In general, consider dental coverage while you're making Medicare decisions, such as whether to go with original Medicare or Medicare Advantage, and while you're shopping for policies, but put health care first.
How to get financial help for dental care
If you lack dental insurance, you may be able to get free or discounted dental care. The first step to see what kind of help is available in your area is to call your county health department.
Or, you can check Tooth Wisdom, which offers a state-by-state map of dental care resources for older adults. The map offers information on programs, including dental schools in some states that offer low-cost care from students to community members.
And the national nonprofit Dental Lifeline Network offers free dental care across the country to qualifying patients 65 and older who can't afford to pay for services. Some states, such as Virginia, also have nonprofit organizations that offer completely free dental care through volunteer dentists.