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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.

Services provided by Empire HealthChoice HMO, Inc. and/or Empire HealthChoice Assurance, Inc. Empire BlueCross Retiree Solutions and/or Empire BlueCross BlueShield Retiree Solutions is the trade name of Anthem Insurance Companies, Inc. licensees of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans, serving residents and businesses in the 28 eastern and southeastern counties of New York State. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. All external sites will open in a new browser window. Please view our website Privacy Policy for more information.

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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