Generally Original Medicare dental coverage is only for limited circumstances involving hospitalization. Original Medicare (Part A and Part B) generally doesn’t cover most dental care, including cleanings, fillings, tooth extractions, dentures, and dental plates. Hospital insurance (Part A) may pay for emergency or complicated dental procedures, for example the reconstruction of the jaw following an accidental injury, according to the Centers for Medicare & Medicaid services (CMS). According to CMS, Congress has not amended the dental exclusion since 1980, when it made an exception for inpatient hospital services when the dental procedure itself made the hospitalization necessary. If you have Original Medicare and want routine dental care, you will generally need to find a plan from a private insurance company.
Enhanced dental policies for seniorsSome dental insurance policies pay for part of the costs for services beyond routine exams and fillings. Some examples include (but aren’t limited to):Endodontics: Root canals, or the removal of a tooth’s decayed or diseased pulp, are the most common use of endodontics. Your family dentist can sometimes perform this repair, or he or she may refer you to a specialist.Periodontics: Periodontal disease comes in many forms and could end up destroying supporting bones around the teeth. Treatment may include the placement of dental implants and treatment for inflammation. A specialist is often required.Dentures: Being fitted for dentures typically requires many extractions, making it a major procedure, possibly involving several visits. Some family dentists now fit patients for dentures. Specialty offices are more familiar with the process and sometimes offer a faster turnaround.Implants: Some adults who have lost a small number of teeth due to an accident or decay might get dental implants. Implants may eliminate the need for a bridge since the implant looks, feels, and works like a regular tooth. An oral surgeon rather than your family dentist typically does this procedure.Orthodontia: This type of service involves braces to align crooked teeth. Most family dentists offer orthodontia.Cosmetic services: Bonding, whitening, and veneers are sometimes covered under certain dental policies. Many family dentists offer whitening.  Types of dental plansThere are two major types of individual dental insurance plans that may apply to seniors:Managed-care plans (often preferred provider organizations, or PPOs) negotiate fees with specific providers. These in-network providers request only your portion of the cost and file any necessary paperwork on your behalf. Procedures performed by out-of-network providers are sometimes covered, but often at a lesser amount.Indemnity plans often include a larger group of providers and you may be able to see the dentist of your choice. The drawback is that patients are often required to pay 100 percent of the bill up front and then file a claim for reimbursement for the covered procedure.You can get help choosing an individual dental insurance planDon’t wait until you feel discomfort to get dental insurance. Many seniors take daily medications that cause dry mouth, which can lead to cavities. Inadequate nutrition can also affect your dental health, reports the Columbia University College of Dental Medicine.Keep in mind that some health problems, like pneumonia and insulin resistance, may be triggered by poor dental hygiene. Research has even found a connection between gum disease and heart disease, Intellihealth News Service reports.If you’d like to explore your options for individual dental insurance plans in your area, just click the button on the right side of this page. You can also request our newsletter in the lower right side of this page if you want to stay up to date on with health and insurance-related updates.This article is for informational purposes only. Nothing in it should be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine. In addition, this information includes just some factors to consider when selecting insurance and may not reflect the provisions of any particular insurance product. Always carefully check the provisions of any insurance product you have or may consider purchasing. wp_cta_load_variation( '10789', '' )#cta_container{ border: 1px solid #dbdbdb; border-radius: 5px; } #wp_cta_10789_variation_0 #cta_container #content {background: transparent;}
*Out-of-network/non-contracted providers are under no obligation to treat Preferred Provider Organization (PPO) plan members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

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Carrington is a provider of discount programs for health and wellness services. It was started in 1979 and is based in Frisco, Texas. Carrington does not provide dental insurance, but rather dental plans where you can get discounts on affordable dental care by becoming a member. You have to pay monthly or annual premiums for your discount plan, but it can be as cheap as $8.95 per month or $89 per year.
Medicare Health Plans is more than just Medicare plans! We work with seniors for all of their insurance needs. One of the most common types of insurance that seniors ask about is dental insurance. Since routine dental care is not included in Medicare and the “gateway” to your body is too important to ignore, seniors want dental insurance options. We represent multiple carriers and plans and believe we have the plans that will best fit your needs.
When shopping for the best dental plans for seniors, you should consider what services and treatments you might need, the costs of the plan, and what the plan covers. The dental needs of seniors could depend on the condition of their current teeth and their dental history. For example, if you already have full dentures, you may be more concerned about getting checked for oral cancer than in cavity treatment or bridges.
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Dental insurance almost always picks up 100 percent of the bill for routine checkups and cleanings. Coverage for common procedures like root canals and fillings are typically covered at 80 percent, although policies with higher premiums cover up to 90 percent. You are then responsible for the remaining 10 to 20 percent of the cost, called coinsurance. Most plans cover higher-priced and more involved procedures at 50 percent, so you should have some savings set aside for what your insurance does not cover. Still, with relatively low premiums, having dental insurance is far less expensive on average than paying cash for all dental procedures.
These dental schools either offer discounts or provide free dental services in order to get patients they can practice on. While they do all sorts of different procedures, it’s probably best to go to them for more routine care like cleanings, check ups, x-rays, and small cavities. If you have a more complex procedure to get done, you might better off going to an expert instead.
The downside of using a dental school is that it can sometimes take a lot more time to get the work done since it’s a learning environment, the hours or days that they practice are limited, and it can be hard to get your insurance coverage to pay for work performed at a dental school if you have insurance. You’ll likely have to pay for your treatment out-of-pocket and get reimbursed later.
The dental insurance and dental plan data on MedicareWire.com comes directly from public and private sources and is subject to change. The MedicareWire.com website is available for educational purposes. Our goal is to present information accurately and without bias, based on our interpretation of factual information. However, this site is not intended as a substitute for legal, health, or financial advice from a licensed professional.
Most people know that they need to visit a dentist regularly. Having dental coverage is strongly associated with how often dental services are used. Americans often say that the cost of dental care and the lack of dental coverage are reasons for not getting needed dental care. Having an individual dental insurance plan from Spirit Dental allows you to get the regular care you need to stay healthy.
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