March 19th 2024
By Ari Parker
Original Medicare doesn’t cover dentures, but you can find Medicare Advantage plans that provide dental coverage.
By Ari Parker
A common source of frustration among Medicare beneficiaries is Original Medicare’s lack of dental coverage. While Original Medicare doesn’t cover dentures, or any dental care, many Medicare Advantage plans include coverage for services related to your teeth.
In this article we’ll discuss the limited coverage for dental care with Original Medicare, how Medicare Advantage plans can cover dentures, and what alternative methods there are to pay for dentures.
While Original Medicare doesn’t cover dentures, you can find many Medicare Advantage plans with routine dental coverage.
You can also get private dental insurance or check if you have local free dental care in your area.
You may need dentures if you have missing teeth due to decay, gum disease, injury, or other dental issues. There are various kinds of dentures that address different levels of tooth loss and needs. Some people need full dentures, and some people need partial tooth replacement.
No matter which kind you need, dentures are typically custom-made to fit your mouth and designed to suit the appearance of your face. A technician usually begins the process by taking impressions of your mouth that they use to create a mold for the dentures. Once the dentures are ready, your dentist will ensure that they are fitted properly and leave you with instructions on how to care for them.
Original Medicare doesn’t cover any routine dental services. This includes teeth cleanings, fillings, root canals, crowns, and dental devices like dentures. However, Original Medicare may cover certain dental procedures if you need them to heal or treat an underlying condition. For example, you could get an oral examination and a tooth extraction covered to treat a mouth infection before cancer treatment.
Medicare Supplement (Medigap) plans also don’t cover dental services or dental devices. You may be able to find a Medigap plan that offers pre-negotiated dental discounts, but only a small number of plans offer these discounts. Another option is to find a Medigap policy that allows you to add dental coverage for an extra premium.
If dental coverage is a priority for you, you can opt for a Medicare Advantage plan. Most Medicare Advantage health plans incorporate additional benefits for dental coverage.
You’ll want to check your plan details for specifics around your dental benefits, but generally Medicare Advantage plans will help pay for services like teeth cleanings, preventative dental exams, x-rays, fillings, crowns, root canals, and dentures. Some Medicare Advantage plans also have monthly or quarterly credits that you can use towards dental items like dentures.
Keep in mind that your out-of-pocket costs can vary with your plan and insurance carrier. Oftentimes people find that the dental coverage provided by their Medicare Advantage plan isn’t as comprehensive as they thought. It’s important to check your summary of benefits or contact your insurance provider to confirm what your out-of-pocket costs will be for dentures so you’re not surprised.
Without insurance, dentures can cost between $1,000 to $4,000 per dental arch or $1,400 to $6,800 for partial sets. While the price can vary significantly depending on a person's needs, dentures are pretty costly if you pay out of pocket. Here are a few alternative ways you can get help paying for dentures:
Purchase private dental insurance plans
If eligible, Medicaid, VA, TRICARE, FEHB, employer insurance, or other insurance may cover dentures
Some dental schools and community health clinics offer discounted or low-cost dental services. Check your local dental school or community health clinic for details
We understand how frustrating it can be to not have access to affordable dental coverage, especially if you need a device as important as dentures. From Medicare Advantage plans to private dental insurance plans, we can guide you through your options for the best ways to save on dental. Get in touch with a Medicare Advisor and see what solutions are available to you today. Call us at 855-900-2427 or pick a time to chat.
