5 Things You Should Know about Dental Health and Medicare

Dental health is important to a person’s overall health and well-being. Medicare is a government-sponsored insurance program that covers a wide range of health-related expenses. However, dental health is not always covered under Medicare plans. Coverage can vary depending on the plan’s specifics. This article will explore five key things you should know about dental health and Medicare.

1. Original Medicare does not cover routine dental care. 

It’s crucial to understand that Original Medicare does not provide coverage for routine dental care, and those who depend solely on the program may need to pay for these services from their pockets. Even though Medicare offers coverage for various medical services, including surgeries and hospital stays, routine dental treatments such as cleanings, fillings, and extractions are not typically covered.

However, it’s worth noting that Medicare may offer coverage for dental care under certain conditions. In instances where dental treatment is deemed necessary due to a medical condition or if it’s included as part of a pre-approved hospital stay, Medicare may provide coverage for these services. Those needing dental care should confirm with their healthcare provider or Medicare to know the conditions that provide coverage for dental care. Failure to take the necessary precautions may end up in hefty medical bills.

2. Some Medicare Advantage plans offer dental coverage. 

Dental coverage is not always included in the benefits package for individuals enrolled in Medicare. Medicare Advantage plans, however, offer a solution by providing coverage for additional services such as dental care. Private insurance companies offer these plans and cover the same services as Original Medicare, in addition to vision, hearing, and dental care.

The dental coverage offered under Medicare Advantage plans is inconsistent across all plans, with coverage for routine care being more commonly provided, such as cleanings and fillings. However, some more advanced procedures, including root canals and dentures, can also be covered. It is important to understand that the level of coverage can vary greatly between plans, so it is crucial to review and compare the details of each policy to make an informed decision.

Selecting the right Medicare Advantage plan with preferable dental coverage can help individuals avoid unexpected out-of-pocket expenses and check their overall healthcare costs.

3. Stand-alone dental policies are available, though they vary widely in detail. 

For those needing dental coverage beyond the scope of Original Medicare or Medicare Advantage plans, stand-alone dental policies are available from private insurance companies. These policies cover routine dental care and complex treatments and procedures. But, it is crucial to bear in mind that the coverage details of these policies vary greatly depending on the insurer and plan. Therefore, individuals must carefully scrutinize the policy details, including deductibles, out-of-pocket limits, and coverage exclusions. It’s best to perform thorough research before choosing a stand-alone dental policy. By doing so, choosing the right dental plan that meets an individual’s needs while being affordable can become a reality. With a stand-alone dental policy, individuals can access a broader range of dental benefits that will help them maintain good oral health, all while keeping the risk of incurring high out-of-pocket expenses at bay.

4. Medigap plans may also offer dental coverage. 

Besides covering gaps in Original Medicare, some Medigap plans may include dental coverage as an optional benefit. Although dental coverage is not typically included in the core benefits of a Medigap plan, reviewing the details of each plan and comparing policies can help individuals determine if dental coverage is available and at what level. Evaluating stand-alone dental policies alongside Medigap plans can assist in finding the right coverage for specific dental needs. Therefore, it is important to take the time to understand and compare different policies to ensure that the desired dental coverage is included in a Medigap plan.

5. There are resources available to help with dental costs. 

Many individuals struggle with the cost of dental care, especially as not all insurance plans cover these expenses. However, options exist to help individuals who cannot afford dental care. Some states offer dental care benefits through Medicaid or discount dental services through community health centers. In addition, some dental providers may provide payment plans or other assistance to help individuals access the dental care they need. It is crucial to inquire about these options when seeking dental care and to research available resources in one’s community. Therefore, it is crucial to know that resources are available to help with dental costs, and individuals should take advantage of them to maintain their oral health.


In conclusion, while dental coverage under Medicare and Medicaid can be limited, options are available to help seniors access the care they need to maintain good oral health. To learn about available Medicare plans, visit this website. Whether through a Medicare Advantage plan, stand-alone dental insurance, or even a Medicaid program, seniors should explore all of their options and carefully consider the level of coverage they need to maintain their health and well-being. Additionally, seniors should maintain good dental hygiene habits, even if their insurance plan does not fully cover their dental care needs. By taking these steps, seniors can ensure they do everything possible to maintain optimal dental health as they age.

Featured Image by F. Muhammad from Pixabay