Supplemental Dental Insurance

2014 Medicare and Medigap Updates

Supplemental Dental Insurance

Medicare, the medical insurance offered by the U.S. federal government, offers quite comprehensive health coverage. However, it does leave some significant gaps in coverage which have necessitated the growth of supplemental insurance plans. One of these gaps is in dental care.

The coverage offered by Medicare is exceedingly limited and some people will go as far as to say that it is non-existent. This is because it does not cover routine dental care or dental procedures such tooth extractions, tooth fillings, tooth cleanings and even dentures. For this reason retirees have to look for supplemental dental insurance if they want dental coverage.

You are probably thinking that if it does not cover common dental procedures and routine dental care then the assertion that dental coverage under Medicare is non-existent is true. Well not exactly. Medicare will pay for dental work in certain circumstances. For instance, it will cover dental exams carried out before a heart valve replacement or kidney transplant, teeth extractions performed before radiation treatment of the jaw or jaw reconstruction after an accident. Medicare covers these services because they are deemed medically necessary.

Medicare may also pay for hospital stays during a complicated dental procedure, but it will not pay for the procedure itself. These costs are covered under Medicare Part A (Hospital Insurance) or Medicare Part B (Medical Insurance) depending on the circumstances.

Medigap, which is Medicare supplemental insurance, is not supplemental dental insurance. This is because just like Medicare, most of these supplemental plans do not cover for routine dental care. There are some insurance companies that will offer supplemental dental insurance under Medigap by taking a different interpretation to the ‘new and cutting edge’ clause in federal law. They interpret this clause to mean that they can include vision and dental care in their plans.

As only a few insurance companies are taking advantage of this loophole in federal law and offering supplemental dental insurance, you may need to do some digging to find one. As this is an additional benefit offered by the insurance companies and which they are not bound to offer, they will definitely translate to higher insurance premiums for beneficiaries.

Another option for supplemental dental insurance is the Medicare Advantage Plans (Medicare Part C). These plans are run by private insurance companies that have been approved by Medicare and must follow strict guidelines. Medicare Advantage Plans provide all the services offered under Medicare Part A and Part B and will sometimes provide Medicare Part D (Prescription Drug Coverage). These plans may also offer supplemental dental insurance as well as vision and hearing care.

There are different kinds of Medicare Advantage Plans and these are HMO (Health Maintenance Organization) Plans, PPO (Preferred Provider Organization) Plans, SN (Special Needs) Plans and PFFS (Private Fee For Service) Plans. Supplemental dental insurance is usually offered under PFFS plans.

Our site tries to stay up to date on Medicare and Medigap but we are limited on our knowledge of private supplemental dental insurance so you will need to check further for better information. Just type supplemental dental insurance into your computer and you can find a large amount of information as well as companies selling it. You may also want to talk to your personal insurance agent about it.