How to Get Better Medicare Dental Coverage after 65

Last Updated : 10/23/20193 min read

There is generally only one way to get routine dental care through Medicare, which is through a Medicare Advantage plan with dental coverage. Medicare Advantage plans are offered by private insurance companies contracted with Medicare so you want to note that the Medicare dental benefits can vary from plan to plan.

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Why do I need Medicare Advantage dental coverage?

According to the government Office of Disease Prevention and Health Promotion (ODPHP), the health of the teeth and mouth is central to a person’s overall health and well-being.  People who don’t visit the dentist regularly for preventive services and dental treatment have greater rates of oral disease.

Poor oral health can compromise your ability to speak, smile, smell, taste, touch, chew, swallow, and make facial expressions. Further, oral diseases as common as cavities and as serious as oral cancer can cause significant pain when left untreated.

Does Original Medicare cover dental care?

Unfortunately, Original Medicare (Part A and Part B) does not cover most routine dental care. If you have oral cancer or an injury to your jaw, you may be covered. However, if you need routine x-rays, cleanings, or fillings, you will generally not be covered by Original Medicare.

If you switch to Medicare Advantage, you may be able to get routine dental coverage through Medicare Advantage.

How can I get dental care with Medicare Advantage? 

As you are browsing through Medicare Advantage plans, scroll to the section that says “Dental Services.” If the plan lists “Medicare-covered benefits” and a copayment, you probably do not have coverage beyond what Original Medicare provides. However, some Medicare Advantage plans list more comprehensive coverage, including coverage for:

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  • Oral exams
  • Cleanings
  • Dental x-rays
  • Diagnostic services
  • Restorative services
  • Endodontics
  • Periodontics
  • Extractions
  • Prosthodontics

How much will I pay for Medicare Advantage dental coverage?

Some of the price of your Medicare Advantage dental coverage may be built into the plan premium, and that is why Medicare Advantage plans with dental coverage typically have higher monthly premiums. Keep in mind that no matter what your Medicare Advantage premium, you still must pay your Medicare Part B premium. You may pay a copayment or coinsurance amount or each service you receive, for example, 10% coinsurance for an oral exam and 50% coinsurance for dental x-rays. Your Medicare Advantage plan may also have a yearly cap on the amount it will pay for dental care every year, for example, $1,000 for covered services in a calendar year.

Some Medicare Advantage plans may require you to use an in-network provider in order to be covered or pay more if you go out of network.

What other benefits do Medicare Advantage plans provide?

As well as routine dental care, Medicare Advantage plans may cover a variety of services that Original Medicare typically doesn’t cover such as:

  • Routine hearing
  • Routine vision
  • Prescription drugs

Do you want to find a Medicare Advantage plan with dental coverage? Just enter your zip code on this page.

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