Medicare Dental Coverage

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Medicare Dental Coverage

Medicare Dental CoverageDoes Not Include

Medicare insurance for seniors includes limited dental coverage. If you have a medical condition that affects your  mouth, Medicare will cover it.  However Medicare dental coverage for seniors does not cover routine dental services. These include x-rays, cleanings and fillings. In addition, they don’t pay for dentures, even if you are in the.

Does Include

Medicare dental coverage  for seniors works to protect your health if :

  • a kidney transplant if needed in a rural or federally qualified health clinic before a heart valve replacement;
  • you have a disease that involves the jaw (like oral cancer) and need dental services that are necessary for radiation treatment;
  • a facial tumor was removed and had ridge reconstruction (reconstruction of part of the jaw) as part of that procedure;
  • surgery is required to treat fractures of the jaw or face;
  • dental splints and wiring is needed as a result of jaw surgery
  • Medicare will not pay for any more follow-up dental care after the underlying health condition has been treated.
  • If Medicare paid for a tooth to be removed (extracted) as part of surgery to repair a facial injury you got in a car accident, it will not pay for any other dental care you may need later because you had the tooth removed.

Seniors can get Medicare dental coverage in a HMO or PPO

Enroll in one of the many Medicare Health Plans, such as HMOs or PPOs that include additional benefits, such as preventive dental, vision, hearing and gym membership. What is covered varies between plans.

If you have a dentist, you will need to check with him to see if accepts the dental plan.

Seniors can enroll in a Dental Insurance plan.

How Dental Insurance works

The policies are easy to understand compared to Medical insurance. The coverage is clear about what is and isn’t covered.

Waiting Periods

Most plans have waiting periods. You may have to wait 6-12 months for standard work.

For major work, the waiting period may be up to 2 years.

If you know what procedures you will need, compare your  monthly costs vs the benefit you’ll get.

Deductibles, Copay and Coinsurance

A deductible is the amount you have to spend before the plan will cover you.

Likewise, after you pay the deductible, the plan only pays a set amount of the cost.

A copay is a set dollar amount.

Coinsurance is a % of the cost you will pay. That could be 20-80% of the total.

Yearly Maximum on Coverage

That is the maximum amount of coverage the plan will give you in a year.

Also, the majority of plans cap have limits ranging between $750 and $2000.

In addition, after the  yearly maximum is reached, the patient has to pay 100% of the costs.

If you don’t reach your annual maximum, the plan may roll it over to the next year.

Cosmetic Procedures aren’t covered

Most plans don’t cover procedures that improve the look of your teeth, rather than health of your mouth.

That means they don’t cover teeth whitening, veneers, tooth shaping or gum contouring.

Now that you understand how private dental insurance works

There are a variety of dental plans that cover diagnostic & preventive services.

The monthly premiums are affordable.

Some of the plans require you to visit dentists in their network,

Similarly, other plans allow you to go out of network.

In addition, some of the plans include vision coverage.

Dental insurance companies include:

Renaissance, Delta Dental, Nationwide

To view the plans available in your zip code.

Then get free quotes on dental and vision coverage.

Dental Insurance:

Enroll in a dental savings plan

How dental savings plans differ from dental insurance plans

Dental Savings Plans are like being a member of Costco or BJs

  • First of all you pay an annual fee
  • The dentist gives you reduced rates
  • Not to mention, you don’t have to pay a deductible
  • Furthermore, there is no paperwork to fill out
  • Also, there are no waiting Periods
  • You can use the plan as often as you wish,
  • There are no annual caps, limits or restrictions
  • In addition, you will also save on, telemedicine, vision, Rx, etc.
  • Finally,  there are more than 100,000 dentists nationwide.

For assistance finding a Dental Savings plan and dentist in your area, follow this link or contact me.

Dental Savings Plans:

For help choosing the right plan, Call Renee Lempert  (561) 704-9302

Email me: