Does Medicare Advantage Cover Dentures?
This article was updated on: 10/06/2018
If you have missing teeth, you probably want to get them replaced as quickly as possible. Your dentist may recommend some type of dentures to restore normal oral function. If you have Medicare Advantage, your plan may cover some of the expenses associated with replacing your missing teeth. Here’s what you should know about Medicare and dentures.
What are dentures?
According to an article published by the U.S. National Library of Medicine, there are two types of dentures: fixed and removable. Crowns and bridges are considered fixed dentures, because they are permanently attached to the teeth. Removable dentures can be taken out of the mouth at any time. Removable dentures can be complete, replacing the entire set of upper and/or lower teeth, or partial, which replace two or more adjacent teeth.
Partial dentures can be made of metal, plastic, porcelain, or other composite materials. Complete dentures are almost always made of plastic. Dentures, whether partial or complete, are considered prosthodontics. If your dentist recommends dentures, you may be referred to a prosthodontist, who is a dentist specializing in restoring and replacing missing teeth.
How does Medicare Advantage cover dentures?
Medicare Advantage is an alternate way to get your Part A and Part B benefits. At a minimum, all Medicare Advantage plans must provide the same coverage as Original Medicare (Part A and Part B), except for hospice care, which is still covered under Medicare Part A.
Except in very limited circumstances, Original Medicare doesn’t cover partial or complete dentures. If you have an oral or facial cancer that damages otherwise healthy teeth and jaw tissue, for example, Medicare may pay some costs associated with restoring affected areas. Generally, however, there is no coverage under Original Medicare for routine dental services, including fillings, extractions, and restorations such as dentures.
Medicare Advantage, however, is offered by private insurance companies contracted with Medicare to provide health insurance benefits to Medicare beneficiaries. These private companies can choose to offer extra benefits in their Medicare Advantage plans above and beyond Part A and Part B coverage. For example, most Medicare Advantage plans include Part D coverage for prescription drugs, and many pay some or all of the costs associated with certain routine vision and dental care. A Medicare Advantage plan may pay for routine cleanings and annual dental exams for their members as part of their supplemental benefits. You must continue to pay your Medicare Part B premium.
Some Medicare Advantage plans also pay fixed amounts toward prosthodontics such as partial or complete dentures. There may be certain conditions or restrictions. You may have to see dental providers within your plan’s network, or choose certain types of dentures in order to use your plan benefits.
It’s important to note that there is a wide variety in these supplemental benefits in Medicare Advantage plans. Not all companies offer plans with dental benefits, and the amount of the dental benefit may vary from plan to plan. Unlike Original Medicare, where premiums are set by the federal government each year, Medicare Advantage plans set their own premiums, and these vary widely from plan to plan. If you choose Medicare Advantage, you must continue to pay your Part B premium in addition to any monthly premium required by your plan.
If you think you want a plan that covers dentures and dental care, it’s important to compare plans in your area and carefully read the plan documents to see what benefits are available and any conditions, such as a provider network, you must meet in order to use them.
Need more information about Medicare Advantage and dentures?
I am happy to help you find the information you need; you can schedule a phone call or request an email by clicking on the buttons below. You can also find out about Medicare Advantage plan options in your area by clicking the Compare Plans button.
Benefits, premiums and/or copayments/co-insurance may change on January 1 of each year.
The product and service descriptions, if any, provided on these Medicare.com Web pages are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable laws, rules, and regulations.