Medicare Dental Plan

The Association for the Advancement of Retired Persons (AARP) supports a dental health plan which provides customized benefits and effectively brings together dental benefits and savings.

Membership benefits include the liberty to visit any licensed dentist of your preference; selection of two plans with enrollment options for individuals or families; no waiting time for preventive treatment; total of three cleaning dates with your dentist every year; and, guaranteed premiums for at least two years.

Medicare and Dental Procedures

Medicare provides very limited coverage for dental services. It does not have any coverage for regular dental care or nearly all procedures like cleaning, dentures, fillings, and tooth extractions.

This is governed by Section 1862 (a)(12) of the Social Security Act states that Medicare does not have dental care plan, “where such expenses are for services in connection with the care, treatment, filling, removal, or replacement of teeth or structures directly supporting teeth. Structures, which directly support the teeth, refer to periodontium. This includes the gingival, periodontal membrane, dent gingival junction, cemented of the teeth, and the alveolar bone (i.e. alveolar process and tooth sockets).”

The patient has no other alternative but to pay for all dental services which gave rise to discount dental plans. Dental exclusion is part of the Medicare program. The rule behind this is that coverage will not be decided by the cost or inevitability of the dental care but by the kind of service provided along with anatomical form on which the course of action is performed. Furthermore, the stipulations states that dental services are an essential part of any covered procedure just like reconstruction of the jaw following unintentional injury.

However, Medicare encompasses the following types of dental services:

  • Extractions performed in preparation for radiation treatment of diseases which involves the jaw. In this case, you need not get any dental payment plans.
  • Oral examinations only (without any treatment) which come ahead of kidney transplantation or replacement of heart valves under prescribed conditions. This examination is covered by Part A if performed by dental professionals who belong to the hospital staff. It is under Part B if this operation is performed by a physician. The purpose of the examination is not meant for the teeth or structures absolutely supporting the teeth. Instead, it is meant for identification before complicated surgical procedures are carried out.
  • Hospital confinement for emergency conditions or difficult dental procedures even if the dental care itself is not covered.
  • Inpatient hospital services related to the provision of dental services that require hospitalization.
  • Payment for teeth wiring if it is performed in connection with treatment of jaw fractures.
  • Dental splints are covered by Medicare dental insurance plans if these are employed in combination with the medication of covered medical disorders.
  • Medicare makes payment for a covered dental procedure regardless of the hospital where it is undertaken. The hospitalization or non-hospitalization of patients does not affect coverage or exclusion of permitted dental procedures.
  • Payment is also approved for services and supplies used to cover dental services.