The Dental Treatment Cost Original Medicare Won't Cover For Seniors

Routine dental care is important, but it happens to be one of the costs Medicare won't cover for seniors. That includes teeth cleanings, cavity fillings, tooth removals, dentures, or implants. Part A of Medicare covers expenses incurred for hospital visits, like the room, meals, and nursing services, while Part B covers the cost of medically necessary care, such as doctor visits, preventive screenings, and medical equipment.

However, there are cases where the program will permit coverage if it is a part of a covered medical procedure or necessary for that procedure to take place. For instance, Medicare can pay for dental exams or treatment when it is vital to lower the risk of infection before a patient undergoes an organ transplant, heart valve surgery, or a valvuloplasty.

Medicare may also pay for dental care when the patient is in cancer treatment, like chemotherapy or T-cell therapy, or if a patient has head and neck cancer in particular. There are other scenarios, too, like if a patient needs dental work after a broken jaw or treatment that a doctor certifies will help a patient manage dialysis during end-stage kidney disease, according to the Centers for Medicare & Medicaid Services. Medicare will also not cover cosmetic surgery for seniors except under certain conditions. For the most part, Medicare members have to pay for dental care out of pocket or buy another plan.

When Medicare does not cover a procedure, the patient pays the full cost, which may be hard to bear. A single dental implant, for example, can cost between $2,000 and $6,000, according to the University of Iowa's dental clinics. This includes the cost of the implant itself, the custom abutment, and the implant crown, in addition to the cost of the surgery to place the implant and any additional fees. One provider, Coast Dental in the Southern U.S., also charges $2,271 for a "deluxe" upper denture. This is why it helps to plan ahead for dental care. Patients should ask their dentist for a written treatment plan that lists the Current Dental Terminology (CDT) codes, then use FAIR Health Consumer's cost estimator to compare local prices. Compare at least two quotes before making a decision.

If that is not an option, patients can explore Medicare Advantage plans, which offer additional coverage beyond what Original Medicare pays for. But know that the benefits are not the same for everyone. Plans under this program often set a yearly cap on dental coverage, and the amount depends on your plan and location. One AARP Medicare Advantage plan, for instance, offers an annual allowance of $3,500 for covered dental services, which includes fillings and crowns. Patients can also use a Health Savings Account (HSA) account to pay for dental treatment, and it is tax-exempt as long as it covers qualified medical expenses like dental care and artificial teeth.