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Does Medicare Cover Dental Implants?

Does Medicare Cover Dental Implants? Medicare is a Health Insurance Program prioritizing senior citizens aged 65 and older. They have a broad category of services and coverage. Depending on which Part of Medicare you sign up for will give you access and coverage for specific situations and medical care. 

Choosing between Original Medicare and Medicare Advantage will give you different medical coverage plans. Parts A and B are also called Original Medicare, and Part C is referred to as Medicare Advantage. Dental implants require surgery that does not fall under the benefits offered by Part A and B as it does not cover the majority of dental care. Nevertheless, Medicare does plan to provide coverage for dental implants. Part C provides a broader range of dental care and procedures.  

What Services Do Medicare Cover – Does Medicare Cover Dental Implants?

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Under certain circumstances, such as part of surgery and in an emergency setting, Original Medicare will provide some dental coverage. It does not, however, cover routine dental care. Original Medicare Part A will cover specific services administered in a hospital with some coverage for complicated dental procedures. Medicare Advantage offers more dental coverage, including dental implants and more. 

Medicare covers many services, but it all depends on which two main options are chosen. Each one comes with different plans and benefits, so it’s essential to apply for the one best suited to your needs or future endeavors. Let’s take a look at the services covered by the whole of Medicare; 

Medicare Advantage (Part C and D):

  • Hepatitis B, pneumococcal disease, and influenza vaccinations
  • Doctor and specialist appointments 
  • Mental health counseling
  • Emergency ambulance transportation 
  • MRI’s and X-rays 
  • Medical equipment such as home oxygen tanks and wheelchairs
  • Speech, occupational and physical therapy
  • Dental
  • Vision 
  • Hearing
  • Prescription drug coverage
  • Emergency room care
  • Laboratory testing

Original Medicare (Part A and B):

  • Inpatient hospital care
  • Skilled nursing facility (SNF) care
  • Hospice care 
  • Home health care
  • Preventive services
  • Therapy services
  • Mental health services
  • X-rays and lab tests
  • Select prescription drugs
  • Chiropractic care
  • Ambulance services
  • Home health services
  • Medical equipment (DME) 
  • Provider services

Part D:

  • Anticancer drugs
  • Immunosuppressant drugs
  • Anticonvulsive treatments (seizure medication)
  • HIV/AIDS treatments
  • Antipsychotic medications
  • Antidepressants 
  • Vaccines that are not covered by Part B

How Do I Go About Dental Implant Application?

Are Dental Implants Covered By Insurance - man at dentist | Healthier Me Today

Enquiring about dental implants is simple. You can contact to find out if you are eligible for Medicare coverage by phoning in and talking to an assistant or asking via the contact options on their website, such as through emailing or clicking the “Talk to Someone” icon provided on the webpage. Once you are informed of the viable information of your options and accessibility, you can follow these steps to get your dental implant application;

Step 1– Find out about Medicare Advantage enrollment through their online resources or call in to speak to one of their consultants.

Step 2– To apply for the Medicare Advantage, you must make sure you fit into one or more of the following categories, 65 or older, qualifying disability, qualifying life events such as loss of income. The yearly enrollment period starts on October the 15th and ends on December the 7th. At this time, if you are already enrolled in the Original Medicare program, you may swap to the Medicare Advantage program.

Step 3– Create a medicare account but keep in mind you may still search on the website without one.

Step 4– Click on the “Find a Medicare Plan” tool 

Step 5– Choose the Medicare Advantage Plan 

Step 6– Type in your zip code and then follow the instructions to get a list of available plans. 

Step 7– Review the plans that are available in your area. 

Step 8– You will see that under “Plan Benefits,” a green checkmark next to “Dental” will indicate the plans with dental coverage.

Step 9– There will be other information like monthly premiums, type of plans, yearly maximum.

Step 10– Find the right plan or plans that fit your needs.

Step 11– Look at the company’s websites that offer these plans. Many company websites will allow you to see if your dentist accepts the chosen plan.

Step 12– If not all of your questions have been answered in the research process, consider calling a consult or broker to inquire about any other questions you may have.

Step 13– Then, simply sign up by following the enrollment steps given by Medicare resources.

Step 14– Make sure that if the plan you enroll in does not offer dental care as a benefit, you talk to a beneficiary about plans that can have dental care add-ons. 

Dental Implants with Medicare – Can I apply For Dental Implants if I am Under 65?

As stated, Medicare aims to aid people 65 and older, but other criteria are also accepted. This includes younger people with disabilities, End-Stage Renal Disease, and kidney dialysis or kidney transplant patients. Those younger than 65 years with specific disabilities who have received Social Security Disability benefits for 24 months can apply for Medicare coverage. Those who have Amyotrophic Lateral Sclerosis (ALS), although these individuals do not have to collect gifts for 24 months. 

Those with ESRD will generally have three months after a course of regular dialysis begins before they can meet the requirements for Medicare. Individuals that meet all the needed requirements for Social Security Disability are often enrolled in Parts A and B, also known as Original Medicare. If the criteria are met but do not qualify for Social Security benefits, they can pay a monthly Part A premium and monthly Part B premium. 

The beneficiaries are given entitlement to individualized assessment deciding if the coverage criteria are met. There isn’t any illness or underlying condition that will disqualify Medicare coverage. Such as long-term care or because their underlying condition will not show improvement. People with long-term conditions like Parkinson’s Disease, Mental Illness, Alzheimer’s Disease, or Multiple Sclerosis that have care orders from their doctor who meets the criteria for Medicare can obtain coverage.      

Does Medicare cover braces or Cover any Other Dental Related Queries?

Medicare Advantage plans containing dental coverage offer many benefits relating to dental health. These include dental X-rays, routine teeth cleanings, fillings, root canals, gum disease treatment, dentures, bridges, crowns, routine dental exams, tooth extractions, and dental implants. 

The coverage of your chosen plan may not include all these benefits, so it is advised to consult with your plan carrier to learn about what your Medicare plan covers dental-wise. Dental care can be added to your existing Medicare Advantage plan.

When signing up for a new Medicare Advantage plan, there will be an option for dental care services during this selection process. If already enrolled in the plan, you can talk to your provider about the available dental coverages. If there is no add-on dental coverage, you can enroll in a stand-alone dental policy.

Something to Sink Your Teeth Into – Medicare Advantage Cover Dental Care?

Dental implants are covered by Medicare but only in the Medicare Advantage plan unless you can have it as an add-on option to your current plan. Part C includes all the benefits of Part A and B, but it has extra services which include a wide variety of dental care options.

 If adding these extra dental services to your current coverage plan, it’s more than likely that an additional monthly cost will be included. If people younger than 65 apply to enroll in the Medicare coverage plans, they first have to meet the criteria and be individually assessed by beneficiaries. Once approved, these will be available benefits, including dental care, but the conditions and accessibility may differ from those of senior citizens 65 and above.

HMT News Team

HMT News Team 

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