Does Medicare Cover Dental?
There are a plethora of articles written by the American Dental Association and the American Medical Association emphasizing that poor dental care can lead to reduced overall health. Some common health issues, aside from gum disease, are diabetes and heart disease. Other health problems can also be traced to the lack of proper dental hygiene.
Studies also show that about 70% of senior adults do not practice regular dental care. I’ve had hundreds of clients tell me “I’ll go to the dentist when I have a problem, but right now my teeth are fine.” In my younger days I used to be one of these people, so I get it.
Dental health care is a significant part of overall health care, so it’s only logical that original Medicare would make this a priority and cover dental care. Right? Unfortunately, the answer to that question is a BIG FAT NO! Original Medicare does not cover dental care. If Original Medicare doesn’t cover it, Supplements don’t cover it. One Supplement company does offer dental discounts, but good luck with that.
This all begs the question, what can you do? Here are a couple of options to help with dental care.
One is obvious, buy your own dental plan. There is no shortage of companies out there that offer plans, but buyers beware. In my experience there is a right place and a wrong place for these policies. Although most generally offer similar benefits and premium types, you must be careful. Keep in mind, their job is to SELL you their plan.
For example, one company will tell you they have no deductible and no dollar amount limit. Sounds good right? What are they not telling you? These tend to be indemnity plans, meaning they have a preset amount they will pay for their approved procedures. This is generally about 35% of the costs of approved procedures.
I’ve been contracted with and had the option to offer these plans in the past, but simple math told me that it was not really a good deal. Therefore, because I watch out for my clients, I never wrote any of that type of business.
Lastly, these stand-alone plans all have a waiting period for major restorative procedures. If you need to have a root canal or a crown for example, you might have to wait a year before they will cover them. Even then, they only pay about 50%.
The second option, which is for those in Medicare, is Medicare Advantage plans. In 2006, there were no Medicare Advantage plans covering dental. Now they all cover dental, but they are not all created equal. In my area of central Indiana there are over 50 plans and as my momma would say “the devil is in the details.”
One company offered up to $2500 of coverage per year. What are they not telling you? They don’t cover bridges. Another is offering $2000 if you are in-network. There are all kinds of variations to consider. We know how to work these systems. Example, in 2022 my wife had a crown put in. The cost was $1300. The way we arranged her care for that year, this ended up costing her nothing. Nada! Zero! Free! One of my favorite words.
Let us help you! We know how to sift through the weeds to find the best coverage for you.