Seniors, Medicare and dental coverage

December 15, 2015

Is-dental-covered-under-Medicare_2020_40096487_0_14120972_650.jpgWhile regularly brushing and flossing your teeth and scheduling a professional exam every six months certainly lessens your risk for dental issues later in life, there is no finish line for dental health. Maintaining your smile and safeguarding the link between your mouth and overall well-being is a lifelong job. As such, it is just as important - if not more so - for seniors to practice proper oral care, which includes visiting the dentist.

According to the National Committee to Preserve Social Security and Medicare, 43.5 million adults age 65 and older received Medicare benefits as of 2013. Though this health insurance program benefits seniors and disabled individuals, it has certain shortcomings, namely with oral health. Learn more about dental coverage under Medicare:

Dental exclusions under Medicare
Coverage for routine dental care is not available under Original Medicare. That means Medicare Parts A and B do not cover standard procedures such as cleanings, fillings and crowns. Currently, Medicare pays for only dental services necessary for procedures that are already covered. For instance, if you have a kidney transplant and need a dental exam prior to the procedure, Medicare will cover that cost, according to eHealth Medicare. Additionally, if you have an emergency dental problem and need to stay in the hospital, Medicare will cover the hospital stay but not the dental procedure. Otherwise, dental procedure costs are out-of-pocket for Medicare beneficiaries. 

"Older adults are at a greater risk for cavities."

Medicare Advantage plans cover dental
Medicare beneficiaries may receive dental coverage under private-company offered Medicare Advantage plans (Parts C and D), according to the Centers for Medicare & Medicaid Services. Not only do these plans cover the benefits under Parts A and B, but they also provide additional services, such as dental procedures and prescription drug coverage.

Senior dental health
Despite Medicare not offering dental coverage, older adults have unique oral care needs. As such, it's important you consider dental care in your retirement plan. For instance, individuals age 65 to 69 take an average of 14 prescriptions each year, while doctors prescribe seniors age 80 to 84 about 18 medications per person each year, according to the American Society of Consultant Pharmacists. A common side effect of these drugs is dry mouth, which puts older adults at a greater risk for cavities. After all, saliva plays a crucial role in neutralizing acid in the mouth, ultimately preventing tooth decay.

What's more, the American Dental Association noted that gum disease is particularly prevalent among seniors, which can lead to tooth loss and pose risks to your overall health. The irritated, painful and swollen gums as a result of this infection may go undetected until the more advanced stages of the disease, meaning you may not experience the consequences until later in life. Regularly visiting the dentist is one of the most effective ways to prevent periodontal disease.

Senior couple smiling and hugging.
Seniors have unique dental care needs.

Options for dental coverage outside of Medicare
Visiting the dentist at least twice each year is paramount to avoiding severe dental health issues. Seniors worried about paying the out-of-pocket costs for exams under Medicare may benefit from a supplementary plan, such as a dental discount card.

The card is like your key to a membership program. For a low monthly payment of about $10, you can receive affordable dental care with discounts of anywhere from 20-50 percent on most standard and specialty dental procedures. For example, with just Medicare coverage, you would pay about $115 out of pocket for a six-month check up with your dentist, but with a dental discount card, you would pay only about $35.

This supplementary dental health plan gives you and everyone in your household access to network of credentialed dentists, so whether you're caring for grandchildren, or your spouse needs coverage too, you can rest assured knowing you'll pay minimal costs for exceptional care.


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