Although Original Medicare covers few dental services – and only under very specific circumstances – you do have options to help pay for routine dental coverage. This post explains how you can get help paying for dental services with Medicare. We also explain why you should not ignore your oral health.

When Does Original Medicare Cover Dental Care?

Original Medicare includes Part A, hospital insurance, and Part B, medical insurance. Neither part covers routine dental services, such as cleanings, fillings, x-rays, or exams. Original Medicare does, however, cover more extreme types of dental care.

For example, if you have an accident that results in a broken jaw, Medicare Part A covers jaw reconstruction surgery. Or, if you've been diagnosed with oral cancer and need to have a tooth removed before radiation treatment, Medicare covers that extraction.

Does Medicare Advantage Cover Dental Care?

As of 2020, more than one-third of Medicare beneficiaries choose to supplement their coverage with a Medicare Advantage (MA) plan. Every Advantage plan must offer the same benefits as Original Medicare. However, they are not limited to this coverage. In fact, over 90 percent offer additional benefits, according to research by the Kaiser Family Foundation.

• 93 percent provide fitness benefits, such as SilverSneakers
• 90 percent include Part D prescription drug coverage
• 88 percent include routine dental care
• 87 percent cover eye exams and glasses
• 83 percent cover hearing aids

These additional benefits are the main reason Medicare Advantage plans have grown so much in popularity.

How to Compare Medicare Advantage Plans

Medicare Advantage plan costs and benefits vary widely, so compare your options carefully. Look at the plan's benefits to be sure you're comparing apples to apples. In addition to benefits, look at the full cost of the plan, including monthly premiums, deductibles, copays, and the yearly out-of-pocket maximum. And remember, even if your MA plan has a monthly premium, you're still responsible for the Part B premium.

If the plan offers prescription drug coverage, review the drug formulary to make sure it includes your medications.

Our Find a Plan tool makes it easy to compare your Medicare Advantage plan options. It's fast, easy, and won't cost you a penny. Just enter your location information, estimated coverage start date, and hit Continue to review Medicare Advantage, Part D, and Medigap plans in your area.

Does Medigap Cover Dental?

Medicare Supplement Insurance plans, commonly known as Medigap, do not pay for dental care. This is because they help pay your out-of-pocket costs for services covered by Original Medicare. And, since Original Medicare does not cover routine dental services, Medigap doesn't either.

Standalone Dental Plan

If you choose original Medicare, or your Medicare Advantage plan does not include dental coverage, a standalone dental plan may be your best bet. They work much the same way medical insurance works, with monthly premiums, co-pays, and in- or out-of-network requirements.

In general, dental insurance covers routine care, including:

• Twice-yearly cleanings and exams, typically with no out-of-pocket cost
• Extractions, typically requiring a co-pay or deductible
• Fillings for cavities and tooth decay, typically requiring a co-pay or deductible
• X-rays, with a possible co-pay or deductible

Not all dental plans include coverage for repairs such as bridges, crowns, and root canals, and those that do typically only cover up to 50 percent.

Most standalone dental plans also have fairly low annual limits on what they pay. For example, AARP members may be familiar with the organization's partnership with Delta Dental. If you belong to AARP, you can buy a standalone dental policy designed specifically for seniors, which is great. However, the annual limit of $1,000 to $2,000 (depending on your plan) can leave you with significant out-of-pocket costs.

Dental Savings or Discount Plans

Note that dental savings and dental discount plans are not dental insurance. Instead, they mimic a grocery club membership. The discount plan includes a network of dental providers, and you pay a fee (either monthly or yearly). When you visit one of these dentists, you show your membership card and receive a discount off the dentist’s standard rate.

Before joining one of these plans, talk to your dentist to be sure they participate. Your dentist may also recommend a savings plan. If you don't have a dentist, review the plan's provider network. It's also a good idea to look at the discounts included to determine whether the membership fee is worth it.

Are There Other Ways to Pay for Dental Care?

Yes, you have several other options to help pay for dental care.

• Dental Lifeline Network: Thousands of dentists across the country provide free or heavily discounted dental services for seniors and at-risk populations through the Dental Lifeline Network. Just click on your state for more details.
• Dental schools: If there's a dental school or college in your area, it may offer low-cost dental services. Some even offer free dental care.
• Dual eligible: If you qualify for both Medicare and Medicaid, you're what's known as dual eligible. Some states' Medicaid benefits include routine dental care. But coverage varies widely, so check with your local Medicaid office to be sure.
• Employer coverage: If you or your spouse still work, you may be able to get an employer-sponsored dental plan.
• State health department: Many areas provide low-cost dental clinics. Your state's health department can tell you where to find one. Or, use this tool provided by the Department of Health and Human Services to find the closest Health Center near you.

You may also talk to your dentist about payment plan options. Many dentists work with a credit source that helps patients pay for their dental services over time. Review terms carefully, though. You may find interest rates rise significantly if you don't pay in full within a particular timeframe.

Do You Really Need Dental Coverage?

In a word: Yes. Most of us think of dental care only as regards our oral health. But your dental health is closely related to your overall health. Researchers have linked untreated dental issues with a variety of chronic conditions, including diabetes and heart disease.

Routine dental care is also instrumental in detecting oral cancer early. And, as with all disease, early treatment significantly raises your odds of beating a cancer diagnosis.

Around 20 percent of Medicare beneficiaries haven't been to the dentist in at least 5 years. Most say that cost was the main deterrent in seeking dental care. A similar number of seniors, around one in five, have untreated cavities. And 25 percent of Americans over age 65 have lost all of their natural teeth.

Preventive dental care – exams, cleanings, x-rays, and fillings – goes a long way toward improving both oral and overall health. And studies have shown people are more likely to get routine care when they have dental coverage.

Even when seniors have dental insurance, though, the cost of treatment is often prohibitive for more complicated issues. For example, a root canal can cost $1,500. If you need dental implants to replace missing teeth, you're looking at $5,000 to $7,500 – per tooth.

Additional Tips

Just as with health insurance, there is great power in being an informed consumer. Take the time to perform your research, comparing plans, coverage, premiums, and providers. For example, if you have a long-standing relationship with a dentist, ask whether he or she accepts the plan you prefer.

When looking for a dentist, do not be afraid to ask for a list of fees, including charges for exams, cleanings, and x-rays. If considering one of the savings or discount plans, ask the provider what discount he or she offers. Even within the same plan, dentists offer varying discounts.

Finally, take advantage of the information provided online. A bit of time spent researching ensures you get the best plan to fit your budget.