Medicare Dental Plans

2014 Medicare and Medigap Updates

Medicare Dental Plans

One of the most frequent questions that keeps coming up is about Medicare dental plans; specifically, does Medicare cover dental plans and if so, what are the conditions that have to be satisfied for this to happen? In this article, we will talk about Medicare dental plans in general, and in particular, clarifying those conditions that activate Medicare coverage for dental procedures.

Unfortunately, Medicare has never been a champion when it comes to footing the bill for dental work. Medicare policies explicitly state that routine dental procedures such as prophylaxis, temporary or permanent filling, even tooth extraction and most notably fitting of dentures are beyond the scope of Medicare. As such, policy owners are required to shoulder all their dental bills independent of Medicare coverage.

In certain cases, however, Medicare policies provide a way for dental fees to be shared if not paid in full by Medicare plans. The operational word in the policy is “routine” as such, non-routine procedures that are tied to Medicare-covered services can actually be covered by Medicare. Common examples include:

• Dental reconstruction or restoration following an injury caused by an accident.

• Tooth extractiosn which are done as a preparatory step for radiation treatment for jaw-related diseases.

• Oral examination done to ascertain the risks associated with procedures such as heart valve replacement are also covered. It should be noted however that only “examinations” are under the scope of Medicare but not the treatment of diseases diagnosed during these examinations.

• Should a patient require extended hospitalization for dental procedures, the hospital fees can be covered by Part A policies even if the dental procedure is itself paid by the patient.

Because of these limitations in the coverage of Medicare dental plans, patients are starting to seek out healthcare dental coverage to augment the shortcomings of Medicare policies. These are more popularly known as discount dental plans and are commonly offered by the same companies that provide private healthcare policies or supplemental medical coverage. Of course, buying discount dental plans will require payment of a premium on-top of monthly Medicare payments.

Still, the cursory nature of Medicare dental plans highlights the need for patients to understand the extent to which they can rely on Medicare for support for dental procedures. Beyond this, is should be up to the patient to find personal solutions that would allow dental coverage outside of Medicare policies.

Unfortunately, Medicare is not designed to cover every facet of healthcare and Medicare dental plans, or the lack thereof, stand as a stirring example of this limitation. Nonetheless, the fact that Medicare shoulders a significant portion of other medical concerns is already a cause for celebration.

Despite its limitations, Medicare is a program that has been proven to work to such a significant degree that it remains one of the most effective systems in the world when it comes to healthcare. So fret not whether Medicare dental plans are beyond the scope of your current policy; as long as you maximize your coverage for Part A and Part B services, you should have the available means to supplement your Medicare with discount dental plans that will allow you to get the dental services you need at cheaper costs.