Which Type of Medicare Plan Covers Dental Benefits?
- Reviewed by John Krahnert, Compliance Director,
Medicare Advantage (Part C) plans may cover routine dental care and other dental services Original Medicare (Parts A and B) doesn't cover. Learn more and find out how to compare plans where you live.
While Original Medicare (Part A and Part B) doesn't cover routine dental care, Medicare Part C (Medicare Advantage plans) may cover dental benefits. In fact, 97% of Medicare Advantage plans covered dental benefits in 2023, according to the Kaiser Family Foundation.1
Medicare Advantage plans with dental benefits may not be available where you live. It's important to carefully review the benefits covered by plans that are available where you live. If dental services are covered, some covered services may require additional costs such as copays, coinsurance, deductibles or additional premiums.
Does Original Medicare (Parts A and B) Cover Dental Plans?
Original Medicare does not cover routine dental care such as cleanings, fillings or dentures. However, Part A may cover certain hospital-related dental procedures for Medicare beneficiaries if they are deemed medically necessary.
For example, Medicare Part A pays for inpatient care costs if you require inpatient jaw reconstruction surgery due to an accident or cancer treatment.
Medicare Advantage Plans (Part C) May Pay for Dental Care
Medicare Advantage plans, also known as Part C plans, are offered by private insurance companies approved by the Centers for Medicare & Medicaid Services (CMS). These plans may include additional benefits that Original Medicare doesn't provide, such as dental care.
The extent of the dental coverage varies depending on the specific plan but may include preventive dental coverage like cleanings and exams along with more extensive treatments such as fillings and extractions.
Choosing an In-Network Medicare Dental Provider
Some Medicare Advantage plans with dental benefits may require you to visit in-network dentists to receive covered dental care.
- Familiarize yourself with network restrictions: When selecting an Advantage plan that includes dental coverage, keep in mind that some policies require you to use providers within their network for maximum savings.
- Evaluate provider options: Before enrolling in a plan with limited networks such as an HMO plan or PPO plan, ensure there are quality dentists available near your location who accept the plan.
- Consider out-of-pocket costs: Medicare Advantage plans with dental benefits may include deductibles, copayments or coinsurance costs for certain services. Be sure to review these costs before choosing a plan.
To find the best Medicare Advantage plan with dental coverage for your needs, compare multiple options and consult resources like licensed insurance agents.
Conclusion
Seniors looking for dental care through Medicare have a few options to explore. While Original Medicare does not cover routine dental services, Medicare Advantage plans may offer some benefits. It's important to note that each plan varies in coverage and cost, so it's crucial to research and compare plans before enrolling.
We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.
1 Freed M, et al. (Nov. 10, 2022). Medicare Advantage 2023 Spotlight: First Look. Kaiser Family Foundation. www.kff.org/medicare/issue-brief/medicare-advantage-2023-spotlight-first-look.
