Dental Insurance

If you’re wondering whether Medicare offers dental coverage, the answer is, “It depends.” Dental coverage is limited under Original Medicare, and you won’t be covered for most routine dental services. However, routine dental coverage may be available as part of a Medicare Advantage plan. Because Medicare Advantage plans are available through Medicare-contracted private insurance companies, benefits may vary by plan.

Most dental insurance policies do not cover any costs for cosmetic procedures such as teeth whitening, tooth shaping, veneers, and gum contouring. Because these procedures are intended to simply improve the look of your teeth, they are not considered medically necessary and must be paid for entirely by the patient. Some policies cover braces but usually require paying for a special rider and/or delaying braces for a lengthy waiting period.

Medicare doesn’t cover most dental care, dental procedures, or supplies, like cleanings, fillings, tooth extractions, dentures, dental plates, or other dental devices. Medicare Part A (Hospital Insurance) will pay for certain dental services that you get when you’re in a hospital. Part A can pay for inpatient hospital care if you need to have an emergency or complicated dental procedures, even though dental care isn’t covered.

Medicare doesn’t cover routine eye exams (sometimes called “eye refractions”) for eyeglasses or contact lenses. Medicare Part B (Medical Insurance) covers some preventive and diagnostic eye exams:

• Yearly eye exam
• Glaucoma tests
• Macular degeneration

Why do I need dental and vision insurance coverage?

If you are in the market for dental and vision insurance and find yourself asking, “Why do I need it?” consider the advantages to your overall health. Our oral and ocular health can be key indicators for detecting the early stages of many health risks and diseases, as well as helps prevent many other health issues.

Medicare dental coverage under Medicare Advantage (Medicare Part C)

If you’d like to get more comprehensive dental coverage under Medicare, you might want to consider a Medicare Advantage plan, available under the Medicare Part C program. Offered through Medicare-contracted private insurance companies, these plans are required to offer at least the same coverage as Original Medicare (except for hospice); in other words, a Medicare Advantage plan would cover dental care under the same situations as Original Medicare. In addition, many Medicare Advantage plans offer additional benefits such as routine dental or vision care, wellness programs, and prescription drug coverage.

While Medicare dental benefits may vary by plan, some of the services you may be covered under a Medicare Advantage plan may include routine dental exams, cleanings, X-rays, fillings, crowns, root canals, and more. Some Medicare Advantage plans may require you to use dentists in provider networks when receiving care, or you may have the option to use non-network dentists but at a higher cost-sharing level; you can check with the specific plan you’re considering for more details.

Keep in mind that there may be certain costs related to your dental coverage, including deductibles, copayments, and or/coinsurance. In addition, you’ll need to keep paying your Part B premium if you enroll in a Medicare Advantage plan, along with any monthly premium required for your plan.

Ashford Insurance understands that your needs are unique

We’re committed to finding you the dental and vision plan that meets your needs.

Dental health is an important part of your overall health. Dental plans can help you plan and budget for the costs of dental care. With a variety of plans available, you can find basic dental coverage for general dental care or choose coverage for major care, such as dental implants.