A lot of people entering retirement wonder about their healthcare options and amount of coverage provided once they leave their employer coverage. Retirees wonder what types of health insurance coverage are available and what procedures are covered.
Medicare, the national health insurance program in the United States, does not generally cover most dental procedures. Medicare Part A (hospital insurance) may cover certain dental services that are medically necessary and provided during a hospital stay, such as surgery to prepare for radiation treatment for the head and neck. However, routine dental care, such as cleanings, fillings, and extractions, are not covered under Medicare Part A.
Medicare Part B (medical insurance) also does not cover routine dental care. However, it may cover certain dental services that are medically necessary, such as dental treatment that is required as a result of a medical condition or injury. For example, Medicare may cover the cost of dentures if they are needed due to a medical condition, such as cancer or HIV/AIDS.
If you have Medicare and need dental care, you may want to consider purchasing a private dental insurance plan or a Medicare Advantage plan that includes dental coverage. You can also check with dental schools or clinics in your area, as they may offer discounted rates for dental services.
Medicare does not consider certain treatments to be “medically necessary” the same way most people do. Learning your options and available resources will help tremendously if you need dental care in retirement.
Routine Dental Care and Medicare Coverage
Routine dental care is one of the most common forms of dental attention seniors get. However, Medicare generally doesn’t cover routine dental visits, because they aren’t considered medically necessary.
Under Medicare, root canals and extractions are not medically necessary, either. This means Medicare usually won’t cover them. Dentures are also not commonly covered under Medicare.
Medically Necessary Dental Care and Medicare
Even though Medicare doesn’t normally cover routine dental care, it does provide coverage for some dental procedures under certain conditions. For example, Medicare might cover a dental exam before an organ transplant. This is because oral health can affect surgery and recovery for transplant patients.
- Dental Care and Medicare Coverage for Family
Medicare may provide coverage for dental care if you have a broken jaw. Medicare will pay for medically necessary dental care during your surgery, but nothing that isn’t required for the overall surgery.
Medicare will also provide coverage for dental care if it is essential to treat a certain health condition. Oral cancer is just one example of a health condition where dental care may be covered.
Part B covers 80 percent of your doctor services, while Part A covers any in-patient hospital stays you might have.
Dental Coverage Outside of Original Medicare
The Centers for Medicare and Medicaid Services (CMS) allow Medicare Advantage plans to offer some additional benefits to their enrolls that Original Medicare doesn’t cover, such as dental care. A lot of Medicare Advantage plans offer dental coverage for fillings, cleanings and even dentures.
Beneficiaries need to keep in mind that there are advantages and disadvantages to enrolling in a Medicare Advantage plan. You shouldn’t just enroll in a Medicare Advantage plan for dental coverage, but consider each plan in relation to your overall health needs.
Stand alone dental plans are another option for dental coverage outside of Original Medicare. These types of plans come with an extra premium and usually include family coverage options as well. There are even stand-alone plans that offer vision, dental and hearing benefits in one insurance plan.
Medicare typically doesn’t cover dental care. However, there are some other dental insurance options available to Americans approaching age 65. A Medicare broker can help you find the coverage that works best for you and your family. Find this post interesting? Subscribe to follow our website for more health related topic.
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