Dental care like gum disease, tooth decay, and tooth loss can all be avoided by maintaining good oral health, which includes getting regular examinations, cleanings, and screenings for oral cancer.
However, with very few and very limited exclusions, standard Medicare does not cover dental care.
Dental Care Exceptions And Gaps Coverage
Since dental health is such an important component of overall health, especially for older individuals who may have chronic health disorders like diabetes or heart issues, it sounds contradictory.
Beneficiaries are currently responsible for routine care like cleanings and fillings as well as services like dentures or extractions.
There are a few specific exceptions, such as when dental services are necessary in conjunction with other medically necessary care, such as when a tooth needs to be extracted during surgery to repair a fractured jaw or when a tumor needs to be removed.
According to the Medicare Rights Center, even once the underlying disease is cured, Medicare won’t pay for any additional care.
According to Louise Norris, a health policy analyst for medicareresources.org, basically, it’s not going to cover anything that we think of as routine dental care that you get by just scheduling a visit to your dentist.
Both dental treatment and your Medicare Supplement Plan (Medigap) are not covered. These programs only cover what original Medicare covers because they are expansions of that program’s benefits.
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Forgoing Care And Disparities Among Beneficiaries
Many recipients forgo dental care entirely due to a lack of coverage. According to a 2019 analysis by the Kaiser Family Foundation, nearly half (47%) of all Medicare beneficiaries had no dental visits in the previous year.
Beneficiaries who are black or Hispanic, have lower incomes, and estimate their health as fair to bad received significantly less care.
It can be expensive to pay for your own dental treatment; in 2018, the average Medicare recipient spent $874 on dental care, and one in five spent more than $1,000.
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