A woman sitting at a computer looking at dental coverage. A woman sitting at a computer looking at dental coverage. A woman sitting at a computer looking at dental coverage.

Medicare Dental Insurance Coverage

Getting crucial dental coverage when you have Medicare

Nearly 60 million Americans rely on Medicare to fill their essential need for health insurance.1 However, Original Medicare and even Medigap plans do not cover dental care in spite of its importance to oral and overall health.

While 78% of Americans currently have dental coverage,2 nearly two-thirds of those with Medicare lack access to oral healthcare.3 With 18% of seniors ages 65 and older having untreated tooth decay,4 it’s important for them to visit the dentist regularly. Yet, almost half of people with Medicare don’t visit the dentist in a given year.5

 

Who has Medicare?

Medicare is the U.S. federal health insurance program for individuals:6

  • 65 years of age and older
  • With disabilities
  • Suffering from end-stage renal disease (i.e., permanent kidney failure requiring dialysis or transplant)

How do Medicare plans compare?7

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Purchasing a Medicare Advantage Plan is often a good way to get dental coverage, so consider only plans that include dental or you will need to purchase separate individual dental insurance.

 

How can those with Original Medicare get dental coverage? 

Among Medicare beneficiaries who use dental services, 19% spent more than $1,000 on out-of-pocket expenses for a year.8  If you have Medicare without dental coverage, you can reduce costs and meet this important need with individual dental coverage by simply paying a monthly premium. 

Dental coverage saves you money by paying for preventive services and reducing your out-of-pocket costs for many procedures by sharing the cost with you. Dental coverage is often designed to pay for: 

  • 100% of routine preventive and diagnostic care such as cleanings and exams.
  • 80% of basic procedures such as fillings, root canals and tooth extractions.
  • 50% of major procedures such as crowns, bridges and implants. 

 

There’s additional value in purchasing dental coverage, because you are more likely to:

  • Avoid future dental problems, thanks to preventive care and early treatment. 
  • Get the care you need since you will probably visit your dentist more often. 
  • Enjoy good overall health because research shows oral care has a positive effect on your overall well-being. 
 

Delta Dental offers a range of plans for individuals and families, so you can get the same valuable dental benefits that employers offer — including access to the nation’s largest network of dentists and great customer service. Delta Dental also offers Patient Direct, a plan that allows you to get a discount from participating dentists in exchange for a membership fee.** Find out more about the individual dental insurance plans that are available through the nation’s leading provider of dental insurance today. 

 

Other dental insurance options for seniors

If you’re looking for other affordable dental insurance options, you may want to consider these other dental insurance options for seniors.

  • AARP dental plans for seniors: Delta Dental also administers affordable dental insurance plans through AARP. With this membership-based program, seniors can reap the benefits of a comprehensive dental plan that extends beyond basic dental care to meet the typical dental care needs of people 50+. Learn more about AARP dental plans with Dental Dental here.
  • Senior benefit programs: Another option for seniors is utilizing a senior or retiree dental program through an employer. These plans are typically more comprehensive and most plans will require annual maximums, deductibles, and out of costs for non-preventative services.

 

Get additional resources from Delta Dental

Looking for more information? Delta Dental can help you learn how to keep your smile healthy with these articles:

 

** Plans and rates may vary. Dental benefits are administered by the independent Delta Dental companies.

 

Source:

1. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/CMS-Fast-Facts/index.html, Fast Facts PDF, Page 1

2. 2018 National Association of Dental Plans Dental Benefits Report 

3. https://www.kff.org/medicare/issue-brief/drilling-down-on-dental-coverage-and-costs-for-medicare-beneficiaries/

4. https://www.nidcr.nih.gov/research/data-statistics/dental-caries/seniors

5. https://www.kff.org/medicare/issue-brief/drilling-down-on-dental-coverage-and-costs-for-medicare-beneficiaries/

6. https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices/whats-medicare

7. https://www.bettermedicarealliance.org/sites/default/files/2017-09/CMS-Medicare-and-You.pdf

8. https://www.kff.org/medicare/issue-brief/drilling-down-on-dental-coverage-and-costs-for-medicare-beneficiaries/