Does Medicare Pay for Dentures

2014 Medicare and Medigap Updates

Does Medicare Pay for Dentures

The question “does Medicare pay for dentures” is one of those concerns that never seem to be put to rest no matter the simplicity of the explanation. There is no instance in the stipulations for Medicare which allows a policy to cover dentures. Other dental needs require qualifying to a certain set of preconditions before they can be covered by Medicare. So drop your “does Medicare pay for dentures” questions for a moment and instead focus on areas that have a little bit more hope of being covered by your Medicare policy.

Here are the procedures that might be covered by Medicare depending on your compliance to the qualifications that govern the payment for such a procedure:

• Dental surgery done to repair damage caused by fractures to the face and jaw will be covered by your Medicare policy.

• Dental examination as part of preparatory tests prior to heart surgery will be covered by Medicare.

• If certain medical procedures essential to your health cannot be done because of a hindrance caused by a dental problem, Medicare will pay for the dental procedure in order to ensure that the more important action can also be done. As a classic example, Medicare will pay for dental services to prepare a client for radiation therapy if he or she has illnesses like oral cancer.

• Removal of a facial tumor which damages certain dental features can be rectified by requesting that Medicare covers the ensuing reconstructive procedure and these are indeed covered.

In order for these procedures to be adequately covered, Medicare will require you to submit documentation that proves your qualifications for coverage. Most notable is the need to secure a doctor’s note which stipulates the extent of your condition and how dental services can help you be in better health than if you were not going to subject yourself to it. However, even this is not a guarantee that your Medicare coverage request will be granted. It is extremely important to talk to a Medicare representative before you do anything in the area of dental services.

Consequently, and much like the answer to the question “does Medicare pay for dentures”, patients should remember that Medicare covers this procedure only one time and does not shoulder follow-up examinations. Medicare is concerned with the immediate condition but does not offer anything to assist you in future needs. For example, complications arising from an extracted tooth following a car accident are beyond the scope of Medicare and will not be shouldered regardless of the circumstance.

Further, Medicare is opening to footing the bill for dental-related hospital stays if the associated condition can become life-threatening. For example, a hospitalization due to a tooth infection arising from a tooth extraction can be shouldered by Medicare but this is only purely limited to hospitalization fees but not doctor’s fees. As such, it is extremely important to clarify the coverage before you admit yourself into any facility lest you will end up paying for certain dental procedures out of your pocket.

So, even if the answer to the question - does Medicare pay for dentures - is a big no, there are still procedures that are covered by Medicare policies. Medicare will do all it can to save you from potentially life-threatening conditions that have a dental component. That is the best that Medicare can offer, but oftentimes it is more than adequate to meet your needs.