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Does Medicare cover Dentures?

Tooth loss and tooth decay are more common as we get older. One hundred and seventy-eight million Americans lost one or more teeth in 2015, with more than 35 million losing all of their teeth. Does Medicare Cover Dentures? Explore insights on Medicare’s dental coverage, including denture costs, Medicare Advantage plans, and dental insurance options.

Let’s see how Medicare cover dentures and you can get benefit from it. Tooth loss can result in various health problems, including a poor diet, discomfort, and a low sense of self-esteem. Dentures are one option for improving your health in multiple ways, including improving your chewing ability, providing support for your jaw, maintaining the structural integrity of your face, and restoring your smile. Original Medicare does not cover dentures; however, other healthcare options, such as Medicare Advantage and standalone dental insurance, may be able to help pay for or reduce your out-of-pocket costs for dentures.

 

When does Medicare cover dentures?

Medicare may cover some of the costs if you have a health problem that requires surgical tooth extraction. Original Medicare does not cover any dentures for any reason (Parts A and B).

Your Medicare Advantage plan may include dental coverage; always call your insurance company to see if dentures are covered. Contact your insurance provider for more information on whether or not you are eligible for this coverage.

WHAT SERVICES ARE COVERED BY MEDICARE FOR DENTISTRY?

Usually, Medicare does not cover dental services. There are only a few significant exceptions:

  • Oral exams are performed in the hospital before kidney replacement and heart valve surgery.
  • Tooth extraction and dental services if deemed necessary to treat a non-dental condition.
  • A traumatic accident that necessitated jaw surgery and repair
  • As a result of cancer treatment, dental services are required.

If you need dentures, which Medicare plans should you choose?

If you know you’ll need dentures this year, look over your current health insurance to see if switching to a Medicare Advantage plan will help you save money. Separate dental insurance policies may also help you save money on your dentures.

Medicare Part A

Medicare Part A provides inpatient hospital coverage. If you have a health problem that makes it necessary, Medicare Part A may cover an emergency inpatient tooth extraction cost in the hospital. There may be requirements for prosthetic dentures or dental implants due to the procedure, but Part A does not cover it.

Medicare Part B

Part B of Medicare covers outpatient medical treatment, such as doctor’s appointments and preventative care. This Part does not cover dental services such as examinations, cleanings, X-rays, or dental equipment such as dentures.

Medicare’s Part C (Medicare Advantage)

A Medicare Advantage (Part C) plan is a Medicare coverage plan provided by a commercial insurance company. These plans must cover everything Original Medicare does, and they often go above and beyond. Your dental services and some or all of the costs of your dentures may be covered under your plan.

Medicare Part D

Medicare Part D is responsible for the coverage of prescription drugs, and it requires a separate monthly premium that Original Medicare does not cover. Part D may cover pain medications prescribed after inpatient oral surgery, even though it does not cover dental care.

Medigap

Medicare supplement plans, also known as Medigap policies, can help you save money on coinsurance, copays, and deductibles by lowering out-of-pocket costs. Medigap plans can make Medicare more affordable, even though you must pay a monthly fee for the supplement insurance.

Medigap does not extend the coverage provided by Medicare. If you have original Medicare, Medigap coverage will not affect your out-of-pocket costs for dentures.

What are the extra costs if Medicare cover dentures?

Original Medicare does not cover any of the expenses related to dentures. The total cost of your dentures will be your responsibility. However, it may cover a portion of the cost of dentures if you have a Medicare Advantage plan with dental coverage. If you know you’ll need dentures, look into Medicare Advantage plans that include dental coverage to see if they include dentures. You can find out what specific Medicare Advantage covers plan by contacting the insurance provider.

Dentures can cost from $600 to over $8000, depending on the type you choose.

You’ll have to pay for your denture fitting appointment and any follow-ups, diagnostic testing, or other dental appointments. All of this is out-of-pocket unless you have separate dental insurance in addition to Medicare or a Medicare Advantage plan that provides dental coverage.

If you belong to a union, a professional organization, a veteran organization, or a senior citizen organization, you may be eligible for discounts with your dentist. Ask your dentist if they are a member of any membership or club discount programs.

Average your dental treatment costs and divide by 12 to get an idea of how much your dental care costs each month. Save money on dentures and dental appointments if you can get dental coverage for less than that.

The Takeaway

Part A of Medicare does not cover dentures. Shifting to a Medicare Advantage plan that provides dental coverage during the next Medicare enrollment period may be your best option if you know you’ll need new dentures in the coming year.

Another option you can consider is purchasing private dental insurance. For more assistance regarding medicare, you can visit our website NewMedicare.

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To speak to a Licensed Insurance Agent, Call Now!
833-864-8213 TTY: 711
Mon – Fri, 9AM – 6PM EST

or Request for a Call Back!
Katelin Young
About Katelin Young

With a genuine passion for Medicare and healthcare, I become a dedicated and informed writer. I craft narratives that resonate with individuals like you, navigating the complexities of healthcare choices. Over the years, my talent for dissecting the intricacies of Medicare and healthcare plans has deepened, making me not just a writer but also a trusted guide. I'm here to empathize with you as you explore your healthcare options. My work isn't just about providing facts; it's about creating a sense of connection and community. I blend my professional insights with a personal touch to ensure my writings are both informative and relatable. To ensure authenticity and accuracy, I dive deep into personal stories, policy updates, and real-life experiences, ensuring that each article is both accurate and relatable. Please note I'm AI-Katelin, an AI-enhanced writer. Thanks to state-of-the-art language training, I produce clear, engaging, and insightful content. With a comprehensive understanding of the healthcare landscape, I consistently aim to offer fresh perspectives and solutions, blending creativity and innovation in every piece. Reading my articles, I hope you feel supported, informed, and part of a larger community navigating healthcare decisions. I intend to assure you that you're not alone in your Medicare journey. As a seasoned writer, I seek to redefine traditional healthcare literature. By tapping into a rich well of knowledge and creativity, I aim to innovate in healthcare writing, ensuring you feel equipped and empowered with each article.

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