As a young person, one soon turns to take care of their teeth. Most people want to care for their smile and prevent future tooth problems. One would think that Medicare also covers dental services, but it seems not. It is not the case, however. Whether you are on Medicare or have your own health insurance plan, it is always important to know your payment options for having a dental visit.
If you are on Medicare and have dental coverage, you may be paying for the service in one of two ways. A routine, preventive visit is free – Dental visits under this category include cleanings, checkups, and exams. You will be charged a copay based on your yearly income in relation to the premium paid during the year. If your copay exceeds $20, you pay 100% of the benefit or deductible.
Does Medicare Cover Dental Services?
Dental treatments are categorized into two more sections: Free Emergency visits and non-emergency visits, which may or may not be covered depending on your plan. These include procedures such as fillings, root canals, crowns, or extractions. The benefit amount is usually calculated by age and is based on the amount of time you have enrolled in the Medicare program. The benefit amount is capped for each year, meaning you won’t have to pay more than $350 over your lifetime.
The majority of dental services fall under the emergency category. These include extractions and broken teeth but are usually covered under a copay, managed care plan, or an individual dental insurance plan. Some plans cover 50% of the cost of other procedures, such as fillings and crowns, but this varies with each project. Services covered by Medicare do not include cosmetic procedures such as whitening treatments that can cost up to $500 each time or gold teeth which can cost even more because they require one visit per week for an entire year.
Services are Covered by Medicare
1. Cleanings
When you have a cleaning, the dentist will check your mouth for any signs of tooth decay or gum disease. Usually, you will be asked to remove any visible plaque from your teeth, and the dentist may perform additional tests if necessary. Before any treatment is given, you will be instructed on maintaining proper oral hygiene at home. Cleanings are usually billed as a preventive care benefit and should not cost you anything.
2. Exams
Seeing your dentist regularly and having an annual exam is essential to ensuring good dental health throughout your lifetime. It is critical to have regular checkups and exams to detect early signs of disease before it causes any significant problems. It often means taking x-rays and cleaning your teeth with a soft brush if necessary.
3. X-rays
X-rays help to document the state of your teeth, bones, and jaw. Because x-rays are taken in such large doses, this can be considered an invasive procedure. Because of the risk involved, X-rays are usually only used when necessary. It is especially true of those under 65. Suppose you take prescription medication or have a history of cancer, radiation treatments, or a weakened immune system. In that case, you may need to take x-rays, but this will be at a higher cost than other patients because it takes part in a clinical research study.
4. Root Canals
A root canal is a procedure that involves the removal of decay within your tooth. It is an invasive treatment and should only be done by a dentist with specific training. The cost of root canals varies greatly depending on the region in which you live and your insurance coverage. Still, root canals are often covered as preventive care and should not be charged to you for any reason.
5. Crowns
Crowns are permanent restorations placed on the top of your teeth or restored where necessary or desired. They are made out of porcelain or metal and can be customized to fit your teeth. If you have broken a tooth, crowns can also help to restore it and keep it from becoming damaged further. Crowns are sometimes covered as preventive care, but if not, you may be responsible for paying some of the cost depending upon your dental insurance.
6. Extractions
Extractions refer to removing healthy or decayed teeth that require immediate attention. If there is little chance that the tooth can be saved due to damage or decay, then your dentist will recommend extraction to prevent further damage.
Answering the Question: Does Medicare Cover Dental Services
No matter your age, taking care of your teeth is essential. You will feel better and be more confident if you have a healthy smile. If you have dental problems and need major work done, Medicare will pay for it. If you have minor procedures or just routine care, then it would be wise to have your health insurance plan. You should still check with your dentist or dental plan to confirm your coverage and ask if there are any limits to the services that would be covered. For example, if you have a crown, you might want a second opinion before having it done so that you know the cost ahead of time and can budget for it.