Does Medicare Cover Dental Implants? Overview
How to get Medicare to pay for dental implants? – Well, several people are wondering the same. They are looking for opportunities to get Medicare dental coverage for dental implants and routine services.
The truth is that Medicare Part A and Medicare Part B do not cover dental implants unless it’s medically necessary.
However, suppose you still want dental implant coverage. In that case, you must acquire a Medicare Advantage Plan (also known as Medicare Part C) that offers ways to avail of Medicare Part A and Part B benefits.
Medicare Advantage plans are also available with private insurance companies that contract with Medicare.
How to get Medicare to Pay for Dental Implants? – Medicare and Dental Implants
Despite numerous improvements in dental care, millions of Americans still suffer tooth loss. The cause could be tooth decay, injury, or periodontal disease.
For many years, the only options of treatment available for missing teeth were dentures and bridges. However, today, dental implants are available.
What Are Dental Implants?
A dental implant is a surgical procedure in which the roots of the teeth are replaced with metal cylinders.
These implants serve as artificial teeth, providing a strong foundation for removable replacement teeth with the same function as natural teeth.
Dental implants are conducted after an extensive review of medical history. It involves a thorough dental examination and treatment plan catering to your needs.
While thinking about the health of your teeth, the first question that strikes your mind must be: does Medicare cover dental implants?
Well, this question is common due to the high cost of treatment. Unfortunately, the answer is a bit complicated as most of the parts of the dental procedure will not be covered unless there is some complication or emergency.
- A dental implant works as a root for the artificial tooth. It is a procedure that replaces damaged or missing teeth.
- Though Medicare Part A and Part B do not cover dental implants, one can still obtain coverage through Medicare Advantage (Part C).
- Medicare only covers dental treatments under inevitable conditions in the event of complications or emergencies.
- Medicaid and other private dental insurance providers may cover dental implant procedures.
- Some organizations can offer discount cards for their dental services to the recipients.
- For more information, visit https://www.medicare.gov/what-medicare-covers/
Does Medicare Cover Dental Implants? – Services Covered by Medicare
Original Medicare will cover necessary dental procedures under the following circumstances:
- Accidental Damage – Accidental damage to the jaw is a case of an emergency that requires immediate surgery.
- The emergence of Disease – A disease that affects your gums or teeth. A dental checkup is warranted before the treatment to prevent and detect a condition that can threaten the procedure. After meeting the conditions, the victim automatically becomes eligible for dental coverage through Medicare Part A. It is the hospital insurance portion that provides inpatient hospital care. As long as the victim stays in the hospital or treatment centers, Part A covers dental procedure costs.
Medicare Part A
Though it is rare to get dental implants done in the hospital, some parts of care can be covered in the hospital setting.
Generally, Medicare Part A covers some dental checkups and dental care, notably before a heart valve replacement or a kidney transplant; however, it will not apply to the dental implant procedure.
Additionally, getting part of your diagnosis or procedure does not necessarily ensure that Medicare will pay for the dental implants you need. It might also be possible that Medicare pays only for hospital admittance without covering dental care. Therefore, it is important to double-check this with the hospital beforehand.
Medicare Part D
Medicare Part D provides you with prescription drug coverage offered by private insurance companies that have to be bought separately from the rest of Medicare.
It is subject to other limitations that don’t apply to Original Medicare.
Private Medicare Part D covers the required medications specific to the situation or a pain relief medication following the procedure.
It has been recommended to always double-check your coverage with private plans before the procedure.
Medigap Plans or Medicare Supplement Plans
Medigap plans are private insurance plans covering fees like deductibles and coinsurance payments.
Medigap plans do not directly help with dental implant coverage. However, Medigap can help cover the Part A deductible when a dental implant procedure is done in a hospital.
Medicare Part C or Medicare Advantage
Medicare Part C or Medicare Advantage is a way to get Medicare benefits through a private insurance company.
It may include routine dental, prescription drugs, and dental plans. However, it is worth checking your location for the offered coverage plans, as they may vary from one place to another.
Medicare Advantage plans are given through private insurance plans and may involve limitations.
Some Medicare Advantage plans cover dental implants, and many plans provide routine dental care, which may cover parts of the dental implant process.
Therefore, using Medicare Advantage can be more complex than Original Medicare. Make sure to weigh your options before making a final decision.
Original Medicare that is Part A and Part B, doesn’t pay for routine dental services. The only dental services covered by Original Medicare are essential parts of a Medicare-covered procedure.
So, if you are still wondering how to get Medicare to pay for dental implants – here is the answer. You might want to look into Medicare Part C, also called Medicare Advantage coverage.
It covers additional benefits that Original Medicare doesn’t cover. However, additional benefits beyond Part A and Part B may vary; therefore, carefully check all available options.