Is den­tal care cov­ered by Medi­care?

The Morning Call - - LIFE/HEALTH - Jim Miller

Q: I will turn 65 in a few months and will be en­rolling in Medi­care, but I am con­cerned about Medi­care’s cov­er­age of den­tal care. Does Medi­care cover den­tal pro­ce­dures? And if not, where can I get den­tal cov­er­age? — Al­most 65

A: Medi­care’s cov­er­age of den­tal care is ex­tremely lim­ited. It will not cover rou­tine den­tal care in­clud­ing check­ups, clean­ings or fill­ings, and it won’t pay for den­tures ei­ther.

Medi­care will, how­ever, cover some den­tal ser­vices if they are re­quired to pro­tect your gen­eral health, or if you need den­tal care for an­other health ser­vice that Medi­care cov­ers to be suc­cess­ful.

For ex­am­ple, if you have can­cer and need den­tal ser­vices that are nec­es­sary for ra­di­a­tion treat­ment, or if you need surgery to treat frac­tures of the jaw or face, Medi­care will pay for these den­tal ser­vices.

Although Medi­care’s cov­er­age of den­tal ser­vices is lim­ited, there are other ways you can get cov­er­age and care af­ford­ably. Here are sev­eral to check into:

Con­sider a Medi­care Ad­van­tage plan:

While den­tal ser­vices are mostly ex­cluded un­der orig­i­nal Medi­care, some Medi­care Ad­van­tage plans do pro­vide cov­er­age for rou­tine den­tal care. If you are con­sid­er­ing join­ing a Medi­care Ad­van­tage plan, find out what den­tal ser­vices, if any, it cov­ers.

Also, re­mem­ber to make sure any Medi­care Ad­van­tage plan you’re con­sid­er­ing cov­ers the doc­tors and hos­pi­tals you pre­fer to use and the med­i­ca­tions you take at a cost you can af­ford. See Medi­care.gov/find-a-plan or call 800-633-4227 to re­search plans in your area.

Pur­chase den­tal in­sur­ance:

If you have fre­quent gum prob­lems and need ex­ten­sive den­tal care, a den­tal in­sur­ance plan may be worth the costs ver­sus pay­ing for care your­self. Ex­pect to pay monthly pre­mi­ums of $15 to $40 or more for in­sur­ance. To find den­tal plans in your state, go to NADP.org and use the “find a den­tal plan” tool. Then re­view a spe­cific plan’s web­site.

Con­sider den­tal sav­ings plans:

While sav­ings plans aren’t as com­pre­hen­sive as in­sur­ance, they’re a good op­tion for those who can’t get cov­ered. How this works is you pay an an­nual mem­ber­ship fee — around $80 to $200 a year — in

ex­change for 10 to 60 per­cent dis­counts on ser­vice and treat­ments from par­tic­i­pat­ing den­tists. To find a sav­ings plan, go to Den­talPlans.com (or 888-6325353) where you can search for plans and par­tic­i­pat­ing den­tists, as well as get a break­down of the dis­counts of­fered.

Check vet­er­ans’ ben­e­fits:

If you’re a vet­eran en­rolled in the VA health care pro­gram or are a ben­e­fi­ciary of the Civil­ian Health and Med­i­cal Pro­gram (CHAMPVA), the VA of­fers a den­tal in­sur­ance pro­gram that gives you the op­tion to buy den­tal in­sur­ance through Delta Den­tal and MetLife at a re­duced cost.

The VA also pro­vides free den­tal care to vets who have den­tal prob­lems re­sult­ing from ser­vice. To learn more about these op­tions, visit VA.gov/ den­tal or call 877-222-8387.

Shop around:

FairHealthCon­sumer.org and Health­careBlueBook.com lets you look up the cost of dif­fer­ent den­tal pro­ce­dures in your area, so you can com­par­i­son shop — or ask your reg­u­lar den­tist for a dis­count.

Try com­mu­nity health cen­ters or den­tal schools: There are many health cen­ters and clin­ics that pro­vide low-cost den­tal care to those in need. All univer­sity den­tal schools and col­lege den­tal hy­giene pro­grams of­fer den­tal care and clean­ings for less than half of what you would pay at a den­tist’s of­fice. Stu­dents who are su­per­vised by their pro­fes­sors pro­vide the care. See ToothWis­dom.org to search for a cen­ter, clinic or school near you.

Send your se­nior ques­tions to: Savvy Se­nior, P.O. Box 5443, Nor­man OK 73070 or seee Savvy­se­nior.org. Jim Miller is a con­trib­u­tor to the NBC “To­day” show and au­thor of “The Savvy Se­nior” book.

While den­tal ser­vices are mostly ex­cluded un­der orig­i­nal Medi­care, some Medi­care Ad­van­tage plans do pro­vide cov­er­age for rou­tine den­tal care.

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