Does Medicare Cover Dental Care? – Forbes Health


Sometimes, Medicare Advantage (often called Part C) plans are approved by the federal government and sold by private insurance companies. Christian Worstell, a licensed insurance agent in North Carolina, said these plans often provide services not covered by Original Medicare, such as dental, vision and hearing coverage. Participants may pay additional fees for these benefits. However, not all Medicare Advantage plans offer dental coverage, so it's important to read the details of your plan carefully.

Medicare Advantage plans are often the best way to get dental coverage, but you can also purchase a separate dental plan from a private insurance company, Worstells said.

What does Medicare dental insurance include?

The specifics of dental coverage vary depending on the Medicare Advantage plan you choose.

For example, Aetna Medicare Advantage offers three types of dental coverage:

  • network: Preventive services such as dental cleanings and X-rays are covered.
  • Direct member reimbursement allowance: You pay for dental care upfront and then submit receipts for reimbursement (up to a certain amount).
  • Optional fringe benefits: You can purchase dental benefits for an additional monthly premium.

According to the Kaiser Family Foundation, 94% of Medicare Advantage recipients have some dental coverage. 14% of them only have preventive coverage, which includes dental exams, dental X-rays and cleanings. Meanwhile, 86% have access to a wider range of benefits, including fillings, root canals, dentures and oral surgery.

How much does dental insurance cost with Medicare Advantage?

In general, the cost of Medicare Advantage plans and dental insurance (especially if there are additional premiums involved) will vary based on factors such as your age and where you live. Some have monthly premiums of $0, while others cost more. For example, in eastern Pennsylvania, Medicare Advantage plan premiums range from $0 to $302 per month. In the Los Angeles area, monthly costs range from $0 to $397.

Low-cost Medicare Advantage plans don't include additional monthly dental insurance premiums and typically include basic dental services such as exams and cleanings, Vostel said.

“More expensive plans [with higher premiums] Includes more advanced dental services such as tooth extractions and dentures as well as other services more relevant to older patients.

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