Original Medicare, sometimes called traditional Medicare or fee-for-service Medicare is comprised of two parts. Medicare Part A provides coverage if you need to be hospitalized, and Part B provides health care coverage. Medicare is an excellent way to reduce the cost of your healthcare. But unfortunately, Original Medicare provides extremely limited dental coverage.
Original Medicare only covers dental treatment when oral health is “inextricably linked, substantially related and integral to” the clinical success of specific, covered medical treatments. These treatments include organ transplant, cardiac valve replacement, and, starting in 2024, head and neck cancer treatment.
Medicare does not cover any type of routine or restorative dental care, such as dental exams, cleanings, fillings, crowns, bridges, and dentures.
Here are the types of Medicare plans, what they cover, and if dental services are available.
|Type of Medicare||What’s Covered?||Is Dental Coverage Available?|
|Helps cover inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care.||No, except as part of specific covered medical treatments.|
|Helps cover services from doctors and other health care providers, outpatient and home health care, and some medical equipment like wheelchairs.||No|
|Medicare Advantage is a private insurance alternative to original Medicare. These plans often include dental coverage, either as part of the plan or as an optional add-on.||Yes, however, not all Medicare Advantage plans include dental. Make sure your plan does before enrolling and check the annual maximum coverage cap.|
|Part D is drug coverage. You can choose a Medicare drug plan, or join a Medicare Advantage plan with drug coverage.||No|
How to get affordable dental care on Medicare
Join a dental savings plan
Dental savings plans, a trusted alternative to traditional dental insurance, helps make dental care affordable. Plan members report an average savings of 50%* on their dental care at more than 140,000 dentists and specialists nationwide – about 70% of all dental practices in the U.S.
While dental insurance typically has annual maximums, deductibles and waiting periods, as well as pre-existing condition restrictions, dental savings plans do not. You can save on the care you need, whenever you need it.
You can save on preventive care such as annual checkups and cleanings, as well as restorative care – like crowns, root canals, braces, dental bridges, dentures, dental implants – even cosmetic procedures that are not typically covered by dental insurance.
See how much you can save with a dental savings plan.Use our calculator below >
Choose a Medicare Advantage plan
Medicare Advantage Plans (MA plans) are provided by private companies that have been approved by Medicare. Medicare Advantage Plans must provide all the services that Original Medicare covers except hospice care.
MA plans may offer extra coverage, like vision, hearing, dental, and/or health and wellness programs. You can often access this extra coverage at no additional cost. MA plans are becoming more popular every year – a Congressional Budget Office analysis projects that by 2030, 55 percent of Medicare beneficiaries will be enrolled in MA plans. But it’s important to review whether Medicare Advantage is right for you, now and into the future.
Medicare and Medicare Advantage plans have some important differences. Under original Medicare, a recipient can go to any provider they choose that accepts Medicare. With a Medicare Advantage plan, people typically must go to a health care provider – which includes dentists – that participates in that private insurance plan’s network, which is typically tied to your location. This can be problematic if, for example, you split your time between two locations or enjoy taking long road trips in your RV.
Also check the details of the dental coverage offered carefully. Lower priced or “no premium” plans may offer very limited dental coverage. Medicare Advantage plans with more comprehensive dental coverage often have higher monthly premiums.
Buy dental insurance
Traditional dental insurance is another option to consider if you have opted for Original Medicare. Just like the coverage offered with a Medicare Advantage plan, dental insurance can be a great option for people who want to maintain their excellent oral health. That’s because dental insurance typically covers preventive care – checkups and cleanings – at 100%, you don’t have to pay out of pocket.
But if you do need restorative care – root canals, crowns, bridges, dentures, and so on – PPO insurance will pay only until you hit your annual maximum (the most they’ll pay for your dental care in a year, typically $1,000-$1,500) then you’ll be responsible for the rest. You’ll want to keep a close eye on your deductibles, annual caps, uncovered procedures, and any waiting periods that limit how soon you qualify for restorative procedures. DHMO insurance does not have annual spending limits or waiting periods, but you will need to see an in-network provider and may have limits on how often you can get specific kinds of dental care.
The cost of an individual dental insurance policy is around $350 a year. For a family, the cost is around $550, annually. Dental savings plans are typically priced at about half of that cost and may include savings on other healthcare services such as vision, prescriptions, and hearing.
Dental savings plans vs dental insurance?
Need help choosing between dental insurance and dental savings plans? Give us a call at 1-833-735-0399. We’ll review your needs and provide a personalized recommendation. We have 20+ years of experience in helping people access affordable, quality dental care by matching them to their perfect dental insurance or dental savings plan. It’s time to find a plan that fits your budget and offers the biggest savings for the dental care you need.
Wondering exactly how much you reduce your dental care costs with a dental savings plan? Get a quick peek by using our calculator below.
*Discount Health Program consumer and provider surveys indicate average savings of 50%. Savings may vary by provider, location, and plan.