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Medicare Supplemental Dental Insurance: What Does it Cover and Cost?

Contributors:  

dental medicare supplemental insurance
Cover the gaps in your Medicare

Since Medicare on its own doesn't cover dental treatment, many Medicare recipients are looking for Medicare supplemental dental insurance. This is typically in the form of a Medicare Advantage Plan, but it can also be a standalone dental plan provided by a private insurer.

In this article, we'll answer the following questions:

  • What is a Medicare Advantage Plan?
  • What is supplemental dental insurance for Medicare?
  • What does it cover?

We'll also take a look at some of the best Medicare dental plans for seniors, and where and how you can find the best dental insurance plan for you.

Does Medicare cover dental?

Basic Medicare doesn't cover dental — that includes cleanings, extractions, fillings, dentures, and all other dental services. That's partly why 65% of those with Medicare lack oral health coverage.

Additionally, 18% of those 65 and older have untreated tooth decay, and this is of course exacerbated in communities of color thanks to lack of access to proper treatment and services.

When does Medicare cover dental?

Remember how we just said that Medicare doesn't cover dental? Well, that's not entirely true, because there are some situations when medical treatment requires dental care.

In these situations, the required dental care may be covered. For instance, your Medicare Part A, which covers treatment in the hospital, can cover emergency dental treatment received in the hospital.

Additionally, Medicare might cover:

  • Oral exams for kidney transplants
  • Oral exams for heart valve replacement
  • Jaw reconstruction after facial tumor removal
  • Jaw surgery after facial trauma

That being said, you shouldn't go into any procedure expecting Medicare to pay for your dental care, because even in the situations listed above, there might be some catch that makes your treatment ineligible for coverage.

Medicare Advantage Plans

Let's just quickly do a reminder of what Medicare is, along with its different parts:

supplemental dental insurance for medicare
Get your teeth covered
  • Medicare Part A: Covers inpatient and hospital treatment
  • Medicare Part B: Covers outpatient and medical treatment
  • Medicare Part C: Medicare Advantage Plans, A + B coverage plus some extra
  • Medicare Part D: Covers prescriptions drugs

That Medicare Part C, or Medicare Advantage Plans, is where you might be able to find a Medicare plan that covers dental.

In this article we will be referring to Medicare Advantage Plans and Medicare supplement plans.

Medicare supplement plans vs Medicare Advantage Plans

Medicare Advantage plans are typically bundled plans that include not just dental, but also vision and hearing coverage. They may also include gym memberships and prescription coverage.

Medicare supplement plans offer coverage for what your Medicare doesn't cover. This means they cover deductibles, coinsurance and copays. It doesn't mean that they cover dental. So if you get a Medicare supplement plan, you can purchase dental packages as add-ons if the insurance company offers it.

Medicare dental plans (MA Plans that cover dental)

Medicare Advantage Plans and Medicare supplements are provided by private companies approved by Medicare.

Some of these plans offer dental services — and the most common types are HMOs, PPOs, PFFSs and SNPs.

The table below shows the main points of each type of plan:

HMO

PPO

PFFS

SNPs

General info

With an HMO you can get some services out of network, but you'll have to pay more

This is a type of Medicare Part C Plan. It covers emergency care, plus treatment with other doctors and specialists. You may go out of network, but you'll pay more

This is another type of Medicare Part C Plan. It will decide how much to cover and how much you will pay

This is a type of Medicare Advantage Plan that is tailored to invididuals who need special services and coverage due to specific health conditions

Prescriptions

Drugs are typically covered in HMOs. If you want Medicare Part D, you must join an HMO that provides prescription cvoerage

Drugs are typically covered in PPOs. If you want Medicare Part D, you must join an HMO that provides prescription cvoerage

Prescription drugs might be covered, and if not, you can join a separate Medicare Part D plan

All SNPs provide Medicare drug coverage through Part D

Primary care provider

In most cases you must choose one 

You don't need to choose a primary care provider

You don't need to choose a primary care provider

In most cases you must choose one 

Referrals for specialists

In most cases you'll need a referral

You don't need a referral in most cases

You don't need a referral

In most cases you'll need a referral

What is Medicare supplemental dental insurance?

Supplemental dental insurance is a separate dental plan from a private insurance company that will supplement your Medicare, or even the Medicare Advantage Plan that you already have. This is an option for you if your Medicare Advantage Plan doesn't provide the dental coverage that you need.

What does Medicare supplemental dental insurance cover?

Supplemental dental insurance for Medicare helps with the gaps in your coverage. For example, you may have reached your annual maximum for treatment coverage with your Medicare Advantage Plan. Or maybe there is a treatment not covered under your current plan that a supplemental plan might cover.

How do you add supplemental dental insurance to your MA Plan?

To choose a supplemental dental insurance plan to add to your Medicare Advantage Plan, you must go through a private insurance company that offers such coverage.

Once you find a plan that offers what you need, it's as simple as signing up, and paying a monthly premium.

You can do this by going to Dentalinsurance.com. This online insurance marketplace makes it easy to search and compare plans, with simple explanations and all the information you need.

Best dental insurance for seniors on Medicare 2022

UnitedHealthcare

medicare dental insurance for seniors
The right dental plan can cover your treatment

UnitedHealthcare offers standalone dental plans that provide routine cleanings and exams, x-rays, fillings and root canals. There is no waiting period for cleanings and exams or x-rays, and just a 30-day and 60-day wait for fillings and root canals respectively.

These plans typically provide 100% coverage for preventive services, 80% coverage for minor work like fillings and 50% coverage for restorative care like crowns and bridges.

Seniors with Medicare are good candidates for these plans as there is no age limit.

Humana

Humana offers affordable dental insurance plans that people with Medicare can sign up for, costing anywhere from $10 to $300 per month, depending on the level of coverage you need.

The treatment covered depends on the plan you choose and can include:

  • Preventative care
  • Routine cleanings
  • X-rays
  • Fillings
  • Oral surgery
  • Root canals
  • Dental implants
  • Dentures
  • Bridges

Preventative services including cleanings, fluoride treatment and x-rays have no waiting period, whereas more involved treatments typically do have a waiting period.

Aetna

Aetna offers three options for people with Medicare looking for supplemental dental insurance:

  • Network plan: With a network plan, you can choose an HMO or PPO. With the HMO plans you must see an in-network dentist, whereas for the PPO plans you can go out of network but you'll pay more. Their plans offer 100% coverage for preventive services as long as you stay in network.
  • Direct member reimbursement allowance: These plans don't require you to stay in network. You pay upfront for your dental care, and then Aetna reimburses you up to the allowance they give you for annual treatment costs.
  • Optional supplemental benefits: This plan is idea for you if your plan doesn't include dental coverage or if you have coverage but you want to increase it. These plans come with a monthly premium and include HMO and PPO plans.

The video below gives some tips on how to find the best dental plan for seniors on Medicare:

https://www.abtinsuranceagency.com | (888) 465-9728 | email [email protected] It can be challenging to find quality, affordable dental plans for seniors. Today I'm reviewing some of the top Medicare dental plan options for 2020, including dental/vision/hearing plans, dental discount plans, free Medicare Advantage dental benefits and stand alone dental PPO Plans. More on FREE Medicare Dental and Vision Benefits: https://youtu.be/KFJdswGQBSo Dental/Vision/Hearing Plan: https://drive.google.com/file/d/1rxqL9YTmG8bE7mEpa17CjdvX3-I1LSKg/view?usp=sharing Dental Discount Plan: https://sites.dpbrokers.com/broker/index/?id=325800&subaffid=?? OR https://tinyurl.com/y2zcgxlb (click "Dental", "Dental Savings Plus") Dental PPO Plans (with no waiting periods): http://www.securitylife.com/personal-plans?agnt=SLTC9VQD Watch Next: Medigap Explained: https://youtu.be/RnXi0LJRNVY Medigap Plans in 2020: https://youtu.be/tIEF7dC9e3o Medicare Explained NEW (Parts A, B, C and D): https://youtu.be/GzjIChyTaa8 Medicare Part D: https://youtu.be/HLZnOcxQbXc Medigap Plan N vs Plan G: https://youtu.be/36lGnPC5sNo

Other ways to finance your treatment

The following table shows other ways you can pay for your dental work.

4 Ways to finance your dental care

Dental insurance

Pay a monthly premium in exchange for more affordable care.

Dental loans

Fund your dental work now and make affordable monthly repayments.

Dental tourism

Pay less for quality treatment abroad.

Dental discount plans

Save money on treatment costs in exchange for a yearly membership fee.

Conclusion

Standard Medicare — Parts A and B — don't cover dental care, unless it's required as part of a greater health procedure.

For many on Medicare, the best option is to get a Medicare Advantage Plan (Medicare Part C) to supplement their original Medicare plan.

These plans are provided by private insurance companies approved by Medicare. If you already have a Medicare Advantage Plan, but you find that it doesn't cover all of your dental treatment needs, you can also purchase a standalone dental plan from a private insurer.

If you still find that your treatment needs aren't satisfied, you may want to check out other financing options, like a dental discount plan, which has a membership fee that you pay in exchange for discounts on all treatments and services.

Dentalinsurance.com makes it easy to get advice on choosing a plan — whether an insurance plan or a discount plan — and comparing the best plans in your area.

Your Medicare supplemental dental plans will vary based on where you live. We have individual articles about dental plans for each state. Choose your state from the dropdown list to find out more.

FAQs

Does Medicare offer dental insurance?

Basic Medicare (Parts A and B) doesn't offer dental coverage. That's why you may want to get a Medicare Advantage Plan (Medicare Part C) to help pay for your dental treatment.

dental insurance for medicare
Oral health is critical for overall health

Does Medicare Part B include dental coverage?

Medicare Part B doesn't include dental coverage. It covers outpatient and medical treatment. It may cover dental care if it's required for greater medical treatment.

Do Medicare supplements include dental?

Medicare supplements can include dental, and in fact there are Medicare Advantage Plans and supplement plans provided by private insurance companies to do just that.

Does Medicare pay for dental in 2022?

No, Medicare, as of 2022, does not pay for dental. To get dental coverage as part of Medicare, you need to get a Medicare Advantage Plan or a Medicare supplement plan.

Does Medicare cover dental implants?

Basic Medicare doesn't cover dental implants. If you want coverage for dental implants, you'll need to find a Medicare Advantage Plan, or buy a standalone insurance plan.

What dental services are covered by Medicare?

Medicare Parts A and B, considered standard, don't offer any dental services. For dental coverage, you'll need to get a Medicare Advantage Plan, a standalone plan, or go another route.

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Contributors:
Natalie used to work as a Community Health Worker and Health Insurance Navigator. She continues to follow her passion for connecting people with the healthcare they need by writing informative content about dentistry and medicine.