Does the Medicare program cover dental services? In what cases does it apply?
Medicare offers a variety of coverage plans that include hospital care, lab tests, surgery, and home health care. Do any of these cover dental services?
Medicare is the main health insurance provider in the United States. Through this federal program, health care is offered to adults over 65 years of age, as well as young people with disabilities and patients with permanent kidney failure.
According to the Centers for Medicare and Medicaid Services (CMS), more than 65 million people are enrolled in Medicare, while almost 90 million Americans rely on health care benefits through Medicare, Medicaid, and the State Children’s Health Insurance Program (SCHIP).
Medicare insurance generally covers medical appointments, illnesses, and accidents. The specific coverage will depend on the plan you are enrolled in, since Medicare divides its coverage into four parts: A, B, C and D.
Part A includes coverage for hospital services, while Part B is intended for services outside the hospital. Part C expands the coverage of A and B; and finally, D covers prescription drugs. But what about dental services? Do they fit into any of the previous plans?
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Does Medicare include coverage for dental services?
In general, Medicare does not cover visits to the dentist. Not one of the parts of Medicare typically covers basic dental services, such as regular cleanings, extractions, fillings, or dentures. However, there are special cases in which specific dental service can be covered.
This happens when the condition of the hospitalized patients is related to or requires some prior dental service, or because the dental service in question is serious.
According to the official Medicare website, this includes the following situations:
- An oral examination and dental treatment before receiving a heart valve replacement or a bone marrow, organ or kidney transplant
- A procedure (such as tooth extraction) to treat an oral infection before receiving cancer treatment services such as chemotherapy
- Treatment for a complication you experience while receiving treatment services for head and neck cancer
Beneficiaries seeking dental coverage should explore Medicare Advantage plans or consider purchasing separate dental insurance policies to ensure their dental needs are attended to.
For more information about dental coverage or to sign up for a Medicare plan that suits your needs, visit the official health insurance website or call 1-800-MEDICARE (1-800- 633-4227).