Understanding Dental Benefits in Medicare: A Simple Guide

March 22, 2024

Medicare is health insurance for people 65 or older. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig’s disease). 

Some people get Medicare automatically, others have to actively sign up — it depends if you start getting retirement or disability benefits from Social Security before you turn 65. 

It comprises various components, each of which addresses a distinct health requirement, much like puzzle pieces. We’re delving into Medicare’s treatment of dental benefits today, with a particular emphasis on Parts A and B and Medicare Advantage.

What are Parts A and B of Medicare?

On a high-level view, most of Part A is devoted to hospital insurance, skilled nursing care, and hospice care. Part B is dedicated to services from doctors and outpatient care.

Do Medicare Parts A & B Cover Dental?

This is where dental care can get a little complicated. Medicare Parts A and B typically do not cover routine dental care, including dental exams, cleanings, fillings, dentures, and the majority of tooth extractions.

There are a few exceptions, though. For instance, Part A might pay for dental care if you require it while in the hospital as part of a more extensive treatment plan. Consider that you are undergoing jaw surgery and that the procedure includes dental work. Since it’s seen as a component of your overall medical care in this instance, Medicare may be able to assist with the costs.

What About Medicare Advantage?

Things start to look up from here. Medicare Advantage Plans, sometimes referred to as Part C, are essentially an enhanced version of the original Medicare program. Medicare-approved private insurance providers provide these plans. One of its features is that many Medicare Advantage plans provide dental insurance. Keep in mind that Medicare Advantage Plans are not required to cover more than original Medicare Parts A and B, so not every MA plan will have dental.

Dental treatment for more involved procedures like crowns, bridges, and dentures as well as more basic procedures like cleanings, exams, X-rays, and fillings can be included in a Medicare Advantage Plan. It’s crucial to remember, though, that dental coverage varies greatly among Medicare Advantage plans. While some provide basic dental care, others might offer more extensive coverage.

Stand-alone Dental Coverage

Because they recognize how important dental health is, many Medicare beneficiaries inquire about dental coverage.  This is the point at which you can begin the dental coverage discussion through a stand-alone supplemental (stand-alone) dental plan.  There are numerous options, as well as dental insurance providers. Each plan offers a variety of coverage options, such as exams, cleanings, fillings, and other dental operations. It is important for beneficiaries to understand that dental plans work well only when they receive dental treatment from in-network providers. As an agent, you must confirm that the dentist they are thinking about is covered under that particular dental plan.


Delta Dental

Pinnacle Financial offers several options for stand-alone dental insurance. One such option, Delta Dental, is well-known for its strong network and benefits. Delta is also available in all 50 states and covers a wide variety of preventative and major services.  This can be a great option for individuals who have a Medicare Supplement plan as they do not cover any dental insurance.

To learn more about the different plan options available to your clients, contact a Pinnacle Financial Services team member today. They can be reached at 800-772-6881 x-7731 or by email at healthsales@pfsinsurance.com.

For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Bob Brzyski

Bob Brzyski

Vice President- Marketing

x7742 | bbrzyski@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881


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