---
title: Seniors, Medicare and dental coverage
description: Maintaining your smile and safeguarding the link between your mouth and overall well-being is a lifelong job.
image: https://blog.edentalsolutions.com/hubfs/Is-dental-covered-under-Medicare_2020_40096487_0_14120972_650.jpg
---

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- Seniors, Medicare and dental coverage

# Seniors, Medicare and dental coverage

 August 30, 2024

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![Seniors](https://blog.edentalsolutions.com/hs-fs/hubfs/Seniors.png?width=628&height=329&name=Seniors.png)Regularly brushing and flossing your teeth and having a professional exam every six months can reduce the likelihood of dental problems later in life. However, dental health is an ongoing process without a definitive endpoint. Preserving your smile and ensuring the connection between oral health and overall well-being requires lifelong commitment. Therefore, it is equally crucial, if not more so, for seniors to maintain proper oral hygiene, including regular dental check-ups.

According to the Centers for Medicare and Medicaid Services, as of July 31, 2024, [89.5% of Medicare enrollees were aged 65 or older, out of a total enrollment of 67.3 million individuals](https://data.cms.gov/summary-statistics-on-beneficiary-enrollment/medicare-and-medicaid-reports/medicare-monthly-enrollment#:~:text=67.3M,With%20Medicare%20Part%20D%20Coverage). While this health insurance program supports seniors and disabled individuals, it has specific limitations, particularly concerning oral health. Explore further information on dental coverage within 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](http://www.ehealthmedicare.com/about-medicare/dental/), 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. 

**Medicare Advantage plans cover dental**  
Medicare beneficiaries may receive dental coverage under private-company offered [Medicare Advantage plans](http://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/whats-medicare/what-is-medicare.html) (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.

These plans often include routine dental care like cleanings, exams, and X-rays, as well as more comprehensive services such as fillings, extractions, and even dentures. Beneficiaries can choose from a variety of plans that best suit their individual needs, with some plans offering extensive networks of dental providers and others providing the flexibility to see any dentist.

**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](http://www.edentalsolutions.com/blog/index.php/considering-dental-care-in-your-retirement-plan/). For instance, individuals age 65 to 69 take an average of [14 prescriptions each year](https://www.ascp.com/articles/about-ascp/ascp-fact-sheet), 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](http://www.mouthhealthy.org/en/adults-over-60/concerns), 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](http://www.edentalsolutions.com/blog/index.php/understanding-gum-disease/).

While Medicare Advantage plans can offer significant savings and added benefits, it's important for beneficiaries to carefully compare plan details, including premiums, copayments, and coverage limits, to ensure they select the most cost-effective and beneficial option for their healthcare needs. Additionally, considering the convenience and accessibility of included dental providers can play a crucial role in ongoing dental health.

Overall, the inclusion of dental coverage in Medicare Advantage plans represents a significant enhancement to traditional Medicare, enabling beneficiaries to maintain better overall health through comprehensive dental care.

**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](https://www.edentalsolutions.com/join.aspx).

The card serves as your ticket to a membership program. By paying a nominal monthly fee of $9.95, you can access budget-friendly dental care with discounts ranging from 20 to 50 percent on various standard and specialized dental treatments. For instance, a routine six-month check-up under Medicare would cost about $115 out of pocket, whereas with a dental discount card, the expense would be reduced to approximately $35.

This additional dental health plan offers you and your entire household access to a network of qualified dentists. Whether you are looking after grandchildren or your spouse also needs coverage, you can be confident that you will receive exceptional care at minimal costs.

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