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Does My Medicare Advantage Cover Dental Services?


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Dental problems are very common. If you’re like most adults in the United States, you’ve probably had a dental cavity (caries) or a more serious dental condition, such as a root canal. According to the National Institutes of Health, 92% of adults age 20-64 have had dental caries in their permanent health. For adults 65 and older, this number increases to 93%.

If you’re interested in a Medicare Advantage plan, you might wonder about Medicare Advantage dental coverage for cavities and other dental conditions.

Medicare Advantage is another way to get your Medicare Part A and Part B benefits from a private insurance company. Medicare Advantage plans must cover everything that Medicare Part A and Part B cover, with the exception of hospice care, which is still covered by Part A. A Medicare Advantage plan may be appealing because it can offer supplemental benefits in addition to what Original Medicare covers. Some Medicare Advantage plans may provide more comprehensive dental coverage than Original Medicare offers.

What is the difference between Original Medicare and Medicare Advantage dental coverage?

Original Medicare (Part A and Part B) generally doesn’t cover routine dental care you receive in a dentist office.

What dental care Original Medicare may cover What dental care Original Medicare generally doesn’t cover
Emergency or complicated dental procedures, such as services you receive in a hospital. This might include setting fractures of the jaw. ·       Cleanings

·       Fillings

·       Tooth extractions

·       Dentures

·       Dental plates

·       Other dental devices.

Medicare Advantage also covers emergency and complicated dental procedures and may cover routine services as well.

What dental care Medicare Advantage dental may cover What Medicare Advantage dental doesn’t cover
·       Emergency and complicated dental procedures

·       Routine services (cleanings, exams)

·       Diagnostic services (x-rays)

·       Restorative

·       Endodontic/periodontal/extractive

·       Prosthodontics  (crowns, bridges, dentures)

·       Other oral/maxillofacial surgery

·       Other services

 

Benefits may vary from plan to plan and change every year.

How much do Medicare Advantage Dental Services Cost?

Medicare Advantage dental services usually come with a copayment or coinsurance. Coinsurance is usually a percentage, for example, 20% while a copayment is a set dollar amount, such as $20. If a certain service is not covered, you may pay 100% out of pocket.

What else should I know about Medicare Advantage dental coverage?

  • Your plan may require you to use dental providers within the plan’s network.
  • There may be an annual limit on dental benefits.
  • You may have to pay a monthly premium to have Medicare Advantage dental coverage in addition to your Part B premium

What other benefits do Medicare Advantage plans have?

As well as routine dental, Medicare Advantage may provide services for other things that Original Medicare generally doesn’t cover, such as:

  • routine vision including eyeglasses
  • routine hearing, including hearing aids
  • fitness benefits
  • prescription drug coverage

Do you want to start looking for a Medicare Advantage plan with dental services? Just enter your zip code on this page.

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eHealth's Medicare website is operated by eHealthInsurance Services, Inc., a licensed health insurance agency doing business as eHealth. The purpose of this site is the solicitation of insurance. Contact may be made by an insurance agent/producer or insurance company. eHealth and Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. We offer plans from a number of insurance companies.