Medicare Dental Coverage

Medicare and other government funded programs can be very complex and difficult to understand. In an effort to better understand and manage their overall health care fees, many have asked “what dental coverage under medicare exists and what is not covered by medicare? Particularly those associated with dental expenses.” The following addresses some of the issues surrounding dental coverage with medicare insurance.

The Original Medicare program consists of health care services that are being paid for by the federal government to almost any doctor in the United States – without prior authorization. Medicare recipients are primarily those who are 65 years of age or older, or those with permanent disabilities.

The Medicare coverage is divided into two primary parts: A and  B. ‘A’ is associated with a hospital insurance program. If you’re eligible under Part A, you can enroll in it without being charged. However, a portion of the premium must be paid, if is not covered by Social Security. Part B has to do with a medical insurance program that covers costs associated with doctors, outpatient providers, medical supplies, surgeries and other related medical costs. Eligibility for recipients under Medicare begins at age 65, at which point you will automatically become eligible for both Medicare Part A and Part B. Supplemental insurance or Medigap policies are available to supplement any coverage not available under medicare. Dental coverage for medicare recipients is limited as you’ll see below.

Medicare And Dental Coverage

With respect to medicare dental coverage and basic dental services, people typically ask “does medicare cover dental?”. According to Section IV.q, of the Medicare Rights Center Index, only limited coverage is available to recipients for both vision and dental fees under Medicare. To that end, fees for treatment that is needed primarily for the overall care of your teeth will not be covered by Medicare. Additionally, normal dental costs, such as routine check-ups, fillings, cleanings and dentures are considered normal expenses for the overall health of your teeth – these costs will not be covered by Medicare. Most dentists do not look to medicare for dental coverage to cover normal dental expenses associated with their patient’s dental treatments.

Dental related costs that will be included under Medicare are limited to those that are necessary for other medically related treatments, such as an oral examination that may be required due to a kidney transplant, dental treatments that are necessary for radiation, such as cancer in or near the mouth. Basically, medicare does not cover the cost of procedures that directly support the teeth as indicated in the statutory dental exclusion which was established by Congress, Section 1862 (a)(12) of the Social Security Act.

There is what is referred to as medicare supplement insurance that covers some routine dental services that is related with your overall health. For example, with a Medicare advantage plan, limited dental services are offered to recipients that may be used to supplement your current plan. Other plans such as medicare dental plans associated with companies such as AARP, Aetna, Blue Cross -; Blue Shield, Mutual of Omaha, Cigna, United Health Care and others can be used by recipients to cover dental expenses not covered by medicare.

Those interested can search the various supplemental dental plans that are available to gain a better understanding of how they work, then compare them to find the best plan that is most suitable for their needs.

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