What Medicare Beneficiaries Need to Know about Medicare Dental Services

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Author: Ruskin Booth

It's interesting that when most people think of Medicare they think of doctor's visits and hospital stays or maybe even Medicare Part D, prescription drug medication. But seldom do they consider ancillary services such as hearing, vision and dental care.

"It's important for Medicare beneficiaries to understand that part of their health care coverage needs to include their dental care," notes Alan Weinstock, insurance broker, at MedicareSupplementPlans.com. "The problem is that Medicare coverage for dental care is very limited at this time. And typical Medigap policies don't cover dental either."

Limited Dental Coverage through Medicare

Currently, Medicare does not cover routine dental care or most dental procedures such as cleanings, fillings, tooth extractions or dentures. Medicare only pays for dental services that are an integral part either of a covered procedure (e.g., reconstruction of the jaw following accidental injury) or for extractions done in preparation for radiation treatment for neoplastic diseases involving the jaw.

Medicare will also make payment for oral examinations, but not treatment, preceding kidney transplantation or heart valve replacement, under certain circumstances. Such an examination would be covered under Part A if performed by a dentist on the hospital's staff or under Part B if performed by a physician.

For this reason, Medicare beneficiaries may want to consider enrolling in a supplemental dental plan to help defray any of their dental costs.

Medicare Dental Advantage Plans

For Medicare beneficiaries who are currently members of a Medicare Advantage plan, some of these plans allow you to select an optional dental coverage benefit for an additional plan premium.

Medicare Dental Advantage plan coverage varies depending on your provider. Some have monthly premiums and an initial enrollment fee. Others have a co-payment for office visits and an annual dollar cap.

Medicare beneficiaries who are currently not enrolled in a Medicare Advantage plan or whose plan does not provide dental coverage may want to choose to enroll in a separate dental plan. Typical plans are PPO dental plans, HMO dental plans and POS dental plans.

Choosing the Right Medicare Dental Plan

Before selecting a dental plan, there are some preliminary questions you should ask:

1. What type of coverage do you need? Consider what treatments each plan covers, such ascleanings, x-rays, root canals and other procedures and what coverage you will need.

2. What dental plans are available? Keep in mind that a DHMO is usually the least expensive; however, they tend to allow less freedom of choice - such as provider -- than a PPO or POS.

3. What is the cost of each plan? This includes things such as monthly premiums, maximum annual limits, co-payments and deductibles.

4. Are there special terms? Look at exclusions, waiting periods and UCR (usual, customary and reasonable) treatment limitations.

Finally, before choosing, shop around and ask friends. Just like if you were choosing Medicare supplement insurance, you would want to talk to knowledge experts like the brokers at MedicareSupplementPlans.com.

The same is true for dental insurance. Before you choose a dental plan, be sure to talk to people you know and trust.

The best Medicare Supplemental Insurance is one that provides full security to the people and hence is called Medigap, Medicare supplemental plans should be beneficial for the people.