If you’re age 65 or more and live in Southern Nevada, you probably rely on Original Medicare to help pay for many of your healthcare services. However, you may be surprised to learn that Medicare doesn’t cover many dental procedures and dental devices. And that can be costly if you experience problems with your teeth or gums.
How Original Medicare Approaches Dental Care
Original Medicare, also known as Part A and Part B, does not typically cover routine dental procedures. Which means paying for your preventive dental exams, cleanings, X-rays, fillings, crowns and bridges is your responsibility.
Dental Procedures Covered by Original Medicare
Some dental care is covered under Original Medicare, however. For example, if your dental needs are related to an accident, injury or illness suffered then Original Medicare may cover a portion of it. Through Medicare Part A, Original Medicare may help pay for a tooth extraction caused by a disease that requires hospitalization or reconstruct your jaw after an automobile accident. Keep in mind though, dental procedures covered by Part A are often complex — only for emergencies, and require a stay in the hospital.
Through Medicare Part B, Original Medicare may pay for a dental exam required as a prerequisite to any major surgeries you need. The surgery would require a hospital stay, with the dental care secondary to another procedure.
Your Dental Options If Medicare Won’t Pay
The good news is Medicare Advantage plans (Medicare Part C) offer routine dental coverage and often additional benefits for vision, hearing and prescription drugs. So you don’t have to live with tooth or gum pain, put off preventive care or pay for all the dental care yourself.
Dental discount cards are also available. They’re not part of the Medicare system, but they can help pay for dental services. These discount cards let you gain access to a network of dentists who provide dental procedures at discounted rates. Typically, there’s an annual fee, however the discounts can be well worth it. The online version of these are through a smartphone app or website. They’re becoming increasingly popular because they’re easy to download and offer great savings — and you don’t need dental insurance to take advantage.
For more comprehensive dental coverage, you can also sign up for a separate individual dental insurance plan. Some plans require you to stay within network, while others allow you to see any dental professional if you’re willing to pay more for the service. Plan premiums can be high, but that cost could be more than offset by lower out-of-pocket fees.
Dental Coverage with Medicare Advantage Plans (Part C)
Why are 24 million seniors projected to choose a Medicare Advantage plan?1 Because it’s an easy, all-in-one plan that combines coverage for routine dental procedures with comprehensive hospital and medical coverage. Not only can a Medicare Advantage plan cover the costs of routine checkups and procedures, but also the dentures that so many seniors need.
Some of the most common dental benefits offered by Medicare Advantage plans are teeth cleanings, tooth extractions, cavity fillings, crowns, root canals, removable dentures and implant-retained dentures. However, each Medicare Advantage plan is unique and has different coverage. So it’s important to read the fine print and understand what you’re eligible for when you sign up.
Medicare Advantage (Part C) is Medicare-approved personal insurance offered by private companies. When you enroll in one of these plans — whether it’s an HMO (Health Maintenance Organization) or a PPO (Preferred Provider Organization) — you’ll still get all the benefits you’re entitled to under Original Medicare, plus many extra benefits that Medicare may not cover at all, such as dental care.
How Can Intermountain Health, Help You?
Although Intermountain Health is not a Medicare agency or an insurance provider, we can help you navigate the complex Medicare system with our network of nearly 300 primary care providers and more than 1,500 specialists. We’re an integrated health system with clinics, hospitals, physician groups and telehealth services, and offer a special program for people who participate in a Medicare Advantage plan.
Our myGeneration Senior Clinics provide many healthcare services all in one location, including wellness checks, treatment of chronic conditions, diagnostic testing, immunizations and laboratory services. With nearly 30+ myGeneration Senior Clinics across Southern Nevada, it’s easy to find one near you — offering more face time with your care team and even same-day access for urgent needs.