Dental assistance programs are becoming increasingly important due to the rising costs of dental care. While Medicare does not offer dental insurance, 94% of Medicare Advantage plans include dental coverage. So, how much do dentures cost with Medicare? With the different Medicare Advantage plans, the costs and benefits can vary. In this blog, we’ll examine which Medicare plans cover dentures.
Which Medicare Plans Cover Dentures?
Medicare Advantage plans (Medicare Part C) offer coverage for dentures. They are an addition to the traditional Medicare plans — Parts A and B. You can apply for these supplementary plans if you are 65 or older or have a disability.
Medicare Plans And Their Denture Coverage
- Medicare Part A doesn't offer coverage for dentures under this plan. It only covers necessary dental services as part of another covered procedure. These may include jaw reconstruction after an accident, dental examinations before an organ transplant, and tooth extractions when treating jaw cancers.
- Medicare Part B offers no coverage for dentures or routine dental services. As with Medicare Part A, it covers medical procedures performed by physicians in medical facilities.
- Medicare Advantage partially covers dentures. It is possible to choose from lots of Medicare Advantage plans with varying benefits. Inquire with your plan administrator about which dental services are covered and how much you will need to pay out of pocket.
- Medigap, also called Medicare supplemental insurance, does not help with denture expenses. It pays out-of-pocket costs for treatments, services, or items approved by Medicare. As Original Medicare does not offer coverage for dental services, Medigap also excludes these services. Adding dental coverage may cost extra.
- Medicare Medical Savings Account (MSA) covers the purchase of dentures. Private insurance companies manage Medicare Medical Savings Accounts. The plan offers a high deductible and a savings account for medical bills. However, denture costs aren't included in your deductible.
Medicare Advantage Plans For Dentures
The Medicare Advantage plan supplements Original Medicare, including routine dental care and dentures. If you're considering any Medicare Advantage plan, first check what it offers, as each plan differs.
How Much Dentures Cost With Medicare
There is usually a coverage limit of $1,000 to $2,000 per year on denture benefits, which are usually replaced every five years. How much do dentures cost with Medicare? It will depend on your situation — you may need to pay part of or the entire cost of your dentures. The coverage you choose during open enrollment will determine the unreimbursed cost of your dentures.
- Part B Dentures: Seniors enrolled in this plan may have to pay the full retail price for dentures as there is no coverage for missing teeth.
- Part C Dentures: Seniors enrolled in this plan can expect to pay less than retail prices for dentures.
Kinds Of Dentures Covered By Medicare Advantage
Dentures come in two types — partial dentures cover gaps in the mouth, while complete dentures provide a complete set of teeth. An implant denture has a titanium root and a cap that screws on top that is surgically implanted in the jaw. Depending on the plan, Medicare Advantage covers both types of dentures or just one type. The dentist can tell people what kind of dentures will work best for them and help them make the right choice.
Other Dental Services Medicare Advantage Plans May Cover
Make sure you go through your Medicare Advantage plan details to understand which dental services are covered and the amount you will need to pay out of pocket. Here are some that the plan may cover:
- Cleanings
- Crowns, bridges, dentures, implants, and other prosthodontics
- Dental diagnostic services
- Inflammation of the mouth and gum disease treatment
- Fillings and other restorative services
- Dental X-rays
- Oral examinations
- Tooth extractions
- Root canal treatment
Frequently Asked Questions:
Original Medicare (Part A and Part B) typically does not cover the cost of dentures or most routine dental services. However, some Medicare Advantage (Part C) plans may include dental coverage, which could cover dentures partially or fully, depending on the plan.
To determine whether your Medicare Advantage plan covers dentures, review your plan's Summary of Benefits or contact your plan provider directly. They will provide information on coverage details, any required copayments or coinsurance, and in-network dental providers.
The cost of dentures without insurance or Medicare coverage can vary significantly depending on factors such as the type of denture (complete or partial), the materials used, and the dental provider's fees. Dentures can range from a few hundred dollars for basic models to several thousand dollars for high-quality, custom-fitted options. It's essential to consult with your dental provider to get an accurate estimate of the cost for your specific needs.
The best Medicare insurance plan for dentures depends on your specific needs and preferences and how much dentures cost with Medicare. Dental coverage through Medicare Advantage plans is generally the best option, but if you want to learn more about your options, check out our resources on cheap dental care without insurance.
