I recently enrolled in Medicare and learned that Medicare does not cover dental care. Why is this? And how should I receive dental care then?
-Brody (Dallas, TX)
Yes, dental care is excluded from Medicare coverage.* Medicare is health insurance that exists because of federal laws that were passed to create it. Initially, as created in 1965, Medicare consisted of Part A and Part B and reflected the restrictions and limitations of most health insurance at that time. (Some additions have been made over time, including prescription drug coverage through Part D.) The federal law that created Medicare benefits has specific provisions that exclude coverage for certain things, like dental care and routine vision services.
Just because something is not covered by Medicare, though, does not mean that it is not needed. You may be able to get assistance through the programs listed below:
- Medicare Advantage Plans: Some Medicare Advantage Plans offer routine dental coverage. Contact your plan to learn about services it may cover, any rules or restrictions, and costs. If you are considering joining Medicare Advantage, make sure the plan suits your other care needs.
- Medicaid: In some states, Medicaid covers some dental services. You may qualify for Medicaid if you have a low income and minimal assets. Contact your local Medicaid office for more information.
- Private stand-alone dental plans: You can purchase a separate dental plan from a private company.
- Reduced-cost or free dental clinics: These clinics are available in many states. Use resources available at NeedyMeds, healthcare.gov, freeclinics.com, and hhs.gov for more information.
- Local hospitals: Call the hospitals in your area to ask if they offer dental clinics, how you can become a patient there, which services they offer and at what cost, and if payment plans are available.
- Federally Qualified Health Centers (FQHCs): FQHCs are health care facilities located in medically underserved areas. People with Medicare are eligible to receive services from an FQHC. Some FQHCs may offer dental care.
- Community Health Centers (CHCs): CHCs provide free or reduced-cost health services, including dental care. CHCs are funded by the Health Resources & Services Administration (HRSA).
- Dental schools: Some dental schools provide low-cost dental care. Dental students work with patients under the supervision of experienced, licensed dentists.
To learn about local resources, you should either contact your State Health Insurance Assistance Program or use the government’s Eldercare Locator tool.
*Note: While Medicare does not cover dental services that you need primarily for the health of your teeth, it does offer very limited coverage for dental care needed to protect your general health. Read more here.
I hope this helps!
How do I receive dental care?
July 18, 2022