Do You Have Dental Coverage included with Your Medicare Health Plan?
You DO NOT – if you have Original Medicare or a Medicare Supplement Plan (Medigap Plan). In general, Medicare Health Plans that do offer dental coverage is often limited to preventative care like x-rays and cleanings.
People typically become accustomed to having dental benefits included in their employers health plan. However, it is not the norm with Medicare and that change is sometimes frustrating. Original Fee For Service Medicare (PFFS Medicare) does not provide any maintenance or cosmetic dentistry benefits.
If you still work after turning 65, you can continue to enjoy whatever dental benefits your employer makes available. Even after retiring, some employers and unions may offer continued coverage for former employees. However, for the majority of Medicare Beneficiaries this will not be the case.
Fortunately, there are many Medicare Advantage Plans that do provide these benefits as Optional Supplemental Benefits (OSB’s). The optional dental services range from preventive to comprehensive services and usually require additional premium separate from the Medicare Health Plan. Availability depends on the plan because not all of them include dental coverage.
Many Medicare Advantage Plans provide dental coverage options using Optional Supplemental Benefits (OSB’s). These are separate plans that can be purchased when you first enroll in the medicare health plan. There is typically a monthly premium associated with basic preventive dental coverage, and a higher premium for more comprehensive services like a filling, a root canal or something more involved.
– Brutus Morgan
So, the good news is that Medicare Dental benefits are available!
Usually, these plans require members to pay for services up front. Then you collect your receipts and submit them for reimbursement. This is a good thing because it gives you more flexibility in choosing dentists and services.
There is also a cap or allowance amount on the services that are reimbursed. You want to pick a plan in which the allowance can be used for both preventive and comprehensive services. Some may even include dentures and implants.
When reviewing a Medicare Advantage plan for all available benefits, be sure to look for dental coverage in the supplemental or optional benefits section. Then determine whether you need more or less of the benefits offered. Make sure the plan provides for a list of services that you tend to use. There will also be plus or minus considerations depending on the availability of in-network and out-of-network services.
It will take a little research, and here are some key points to look for:
- You want to see any licensed dental provider (i.e. No Network limits) in the U.S. The dentist should accept Medicare Patients and has Not opted out of Medicare.
- You also want to be able to use out-of-network dentists.
- Lastly, you want to easily find them wherever you are geographically in the U.S. especially if you are traveling – either by looking them up online or calling your health plan customer service.