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Health Insurance Basics

3 Options for the Dental Care Medicare Doesn’t Offer

December 18, 2018

Original Medicare Part A and Part B cover a broad range of hospital and outpatient services, but routine dental care isn’t included. Instead, you’ll generally need to find other insurance options or pay for cleanings, fillings, extractions and other dental procedures yourself. Medicare Advantage plans, also called Medicare Part C, are a popular, affordable alternative to paying these costs all on your own.

What Original Medicare Covers

Original Medicare only covers dental work if it’s necessary for a more serious medical procedure — generally one performed in a hospital. Examples of procedures that might be covered include:

  • A dental exam before surgery to detect any possible infections
  • Tooth extractions required for radiation treatments to address oral cancer
  • Emergency reconstructive jaw surgery

However, while Medicare might cover such treatment, it probably won’t cover follow-up care provided by dentists or oral surgeons in their private offices.

1. Medicare Advantage Options

Many Medicare Advantage plans (Part C), offered by private insurance companies, provide added benefits that include routine dental care. Because they’re created by different private insurers, their specific additional benefits can vary widely. Depending on the plan, you might find coverage for:

  • Routine dental exams
  • Dental cleaning
  • X-rays
  • Fillings
  • Crowns
  • Root canals

Keep in mind your limitations and costs, such as deductibles, might also vary. For example, some plans require you to use their own network of dentists. Or, a plan might allow you to find a dentist outside their network, but charge you a higher copay. You’ll want to read through any Medicare Advantage plan you’re considering to understand what dental coverage you might be eligible to receive.

2. Standalone Dental Insurance

Separate, standalone dental insurance that isn’t related to any Medicare plans is another option. These plans generally cover regular preventive care, including exams, x-rays and cleanings. There may be yearly caps placed on more expensive dental work, such as crowns and root canal procedures.

3. Dental Discount Cards

Dental discount cards can also provide some cost relief for your dental needs. These aren’t insurance plans. Instead, these cards give you access to a specific network of dentists who have agreed to provide their services at a discounted rate. You pay an annual fee for the card and present it to participating dentists to receive their lower rates.

You can learn even more about your dental insurance options by reading this blog post.

Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWI), underwrites or administers PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare Health Services Insurance Corporation (Compcare) or Wisconsin Collaborative Insurance Corporation (WCIC). Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensees of the Blue Cross and Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co- payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium.

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