Medicare is a valuable resource for millions of Americans, but it doesn’t cover everything. If you’re unsure whether your current Medicare plan can help you pay for the cost of dental implants and other essentials, this guide will tell you everything you need to know.
Does Original Medicare Cover Dental Implants?
Original Medicare (Parts A and B) does not typically cover standard dental care or implants.
Medicare Part A (hospital insurance) and Part B (medical insurance) focus primarily on medical needs and preventive services. That means most dental treatments are excluded from coverage.
Routine cleanings, fillings, tooth extractions, and dental implants are all generally not covered by a typical Medicare plan. That’s why many seniors consider alternative supplement plans and coverage options for their dental needs.
Does Medicare Cover Dental? The Exceptions
Although the typical answer to “Does Medicare cover dental implants” is “no”, there are specific, rare situations where Medicare could help you pay for certain costs.
Medicare may cover certain dental procedures if they’re directly related to medical treatments considered “necessary” by a licensed professional. For instance, coverage may be offered for:
- Hospital-Linked Dental Services: Medicare covers certain dental services provided during a hospital stay due to medical conditions or the severity of the procedure.
- Pre-Treatment Dental Procedures: Medicare may contribute to a dental procedure if it’s essential for the success of a covered medical treatment, such as a dental treatment before an organ transplant, a tooth extraction for an infection or cancer treatment, or a treatment for complications that occur from head and neck cancer therapy.
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Alternative Coverage Options for Dental Treatments
While original Medicare doesn’t cover dental implants, you do have other options you can explore that could help you to reduce health costs, such as:
Medicare Advantage (Part C) Plans
Some Medicare Advantage (Part C) plans offer additional supplemental benefits, such as dental coverage. In some cases, these benefits can extend to dental implants, but it’s worth remembering that advantage plans can vary. Review the plan’s benefit summary carefully before you enroll.
Standalone Dental Insurance Plans
Private dental insurance plans frequently include coverage for dental implants and other procedures. However, like all insurance plans, these policies will have their own monthly premium attached to them. Some also may have a waiting period to consider before major procedures are covered.
Health Share Plans
Health sharing plans allow members of a plan to pool their resources and share healthcare costs. With these plans, you can reduce the costs of various treatments and forms of care, including dental treatments. These plans do have their own distinct rules to consider, however.
Discount Dental Plans
Discount dental plans allow participants to access reduced or “preferred” rates for various dental services offered by participating providers. They’re not the same as insurance – and need to be purchased separately. However, they can lower the cost of dental implants.
Understanding Out-of-Pocket Costs for Dental Implants
Since the answer to the question “Does Medicare cover dental implants” is typically “no”, you’ll need to be prepared for a few out-of-pocket costs, if you don’t have additional coverage.
The cost of dental implants can vary widely depending on your chosen practice, the complexity of the procedure, and even your location. You may also need to pay more for extra procedures, such as bone grafting and aftercare.
Prices typically range from around $3,000 to $5,000 per procedure, but most of the time, you’ll need to contact your dentist for a personalized quote.
Financial Assistance Options
If the out-of-pocket costs of dental care are daunting, there are a few financial assistance methods you can consider, such as:
- Health Savings Accounts (HSAs): Health Savings Accounts are excellent for saving cash and employer contributions towards future health requirements, including dental expenses.
- Flexible Spending Accounts (FSAs): FSAs allow you to set aside pre-tax dollars for healthcare expenses, including dental care.
- Payment Plans with Providers: Many dentists offer installment payment plans to make dental implants more accessible, so ask around for options.
Considering all of these options carefully, as well as additional coverage plans, could make dental implants more financially manageable if you’re worried about fees.
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Dental Coverage Options: Final Thoughts
Simply put, the answer to “Does Medicare cover dental implants” is usually “no”, so you may need to consider other coverage options and sources of financial support for your dental treatment.
Understanding your options, and choosing the right strategies to prepare for future costs can help to protect you from significant expenses, and even give you access to valuable discounts.
Do you need help finding the right coverage for your dental needs?
Get a free consultation with one of our Personal Benefits Managers to review your Medicare coverage and learn about supplemental dental plans.
For Further Reading:
Leslie Alford is a Personal Benefits Manager at MediGap Advisors. Leslie has a passion for bringing clarity to those confused about Medicare. She is an authority on Medicare, Medicare supplement plans, Medicare Advantage plans, and Part D prescription drug plans. Read more about Leslie on her Bio page.