Isn’t it great to go to the doctor’s office and know you aren’t going to have to pay for most of the charges because you have insurance? Unfortunately, it doesn’t always work that way at the dental office. Having Medicare insurance does not mean your dental work is going to be covered. In fact, many dentists do not accept Original Medicare insurance because it simply does not pay for most dental needs.
Why Don’t Most Dentists Accept Medicare Insurance?
Medicare covers the majority of any medically necessary services, and it covers preventive services like vaccines and annual checkups. Basically, it covers services that help your general health. It does not cover most dental services.
Medicare will only cover some dental services you may need when you are in the hospital. Either emergency treatment or complicated dental procedures that require hospitalization may be covered under Medicare Part A which is Hospital Insurance. The dental care itself will not be covered.
The majority of the average dental practices focuses on routine dental care. It is not cost effective for dentists to accept Medicare Insurance when the system does not pay for any of the care they normally provide.
What To Do When Your Dentist Doesn’t Accept Medicare Insurance
Since Medicare insurance only covers certain types of dental care, when you are hospitalized, what are your options for routine dental care?
You may be able to enroll in a Medicare Advantage plan. This is also known as Medicare Part C. Under this coverage, routine dental care is covered. You will need to ask your dentist if he or she participates in this program. Medicare Advantage plans utilize private health plans such as Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO), Private Fee-for-Service (PFFS) and other plans.
You will need to have Medicare parts A and B in order to participate in the Medicare Advantage plan. Also, be aware certain plans are available in certain areas. You will need to do some research to find out what Medicare Advantage plans are available in your area. The costs of these plans can vary also. Additionally, you’ll have to pay a monthly premium, and most likely a copayment or coinsurance at the time of service.
You also have other options available, such as Medicare supplement insurance also known as Medigap. Costs not covered by Original Medicare Insurance may be covered by supplemental insurance. The coverage for dental work is an additional option that you will need to request, and it is not offered by all insurance companies supplying supplemental Medicare insurance.
At PCP for Life, we encourage our patients to get regular dental checkups and practice good oral hygiene. Many serious health issues have been linked to poor oral care. We provide you and your family members with affordable, excellent medical care, and we want you to be proactive in maintaining good health. See your dentist for annual checkups.