Does Medicare Cover a Root Canal?
This article was updated on: 09/10/2018
If you’ve ever had a dental emergency, you might be familiar with the cost of a root canal. Managing the root canal cost (which can be up to $5,000 according to Authority Dental) can be a challenge, especially since Medicare doesn’t typically cover dental care, not even a root canal to treat an urgent dental problem.
Here’s what you need to know about root canal therapy and Medicare coverage of the cost of a root canal.
Why do I need a root canal?
The Mayo Clinic says you may need a root canal if you have a cracked, broken, or severely decayed tooth which has become infected, causing pulp death, bone loss, and ultimately loss of the tooth itself. A root canal is a dental treatment that can save the tooth by cleaning the affected roots, and permanently filling and sealing them with dental amalgam. The procedure may be performed by a dentist called an endodontist, who is a specialist in saving teeth, according to the American Association of Endodontists (AEE). In most cases, a tooth treated with a root canal will need a crown to protect the treatment and restore the tooth.
What happens during a root canal?
The American Association of Endodontists (AAE) describes the process like this:
- The dentist numbs the affected tooth and places a dental dam around it to keep it clean and dry during the procedure.
- She then drills a small hole in the tooth, inserts special instruments into the hole to clean the infection from the canals, and shapes the tooth for filling and restoration.
- The canals are filled with a rubbery material called gutta-percha and then sealed.
- The dentist then places a temporary filling to close the hole.
- A crown or other restoration is placed to restore the tooth and return it to full function.
How much does a root canal cost?
The root canal therapy itself is often the least expensive part of the treatment. The cost of a root canal is generally between $300 and $2,000 according to Authority Dental. A crown, on the other hand, can cost up to $3,000. That puts the total root canal cost at around $5,000, although if you are one of the lucky ones who doesn’t need a crown, your root canal filling could cost as little as $90 to $300 reports Authority Dental.
Does Medicare cover the cost of a root canal?
Unfortunately, Medicare does not cover most dental procedures, including a root canal. The only dental coverage Medicare usually provides is when you need certain emergency procedures while you are in the hospital for a condition such as cancer of the jaw.
How can I get help paying the root canal cost?
Medicare Advantage (Medicare Part C) is another way to get your Original Medicare benefits. Some Medicare Advantage plans offer additional benefits, such as covering part of the cost of a root canal, that aren’t available under Original Medicare. Keep in mind, however, that dental benefits may be subject to annual caps and price restrictions.
If you are enrolled in Original Medicare and need help with a root canal cost, you will generally need to enroll in a stand-alone dental plan. It’s important to remember, however, that these dental plans may require you to get your dental care within the plan’s network and that you may be required to pay a deductible and copayment or coinsurance amount. Your benefits may also be capped each year and there may be a one-year waiting period before you qualify for dental work like root canals and crowns.
Not every plan type and benefit option may be available in every location, so be sure to read your plan documents before you select a Medicare Advantage plan or stand-alone dental plan.
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