Still No Coverage for Dental Care

Despite recent advancements in coverage for preventative care, Medicare still does not not cover dental care that is primarily related to the health of your teeth. For example, Medicare will not cover routine checkups, cleanings or pay for fillings or dentures, even if Medicare has paid to have a teeth pulled (extracted) as preparation for a medical procedure.

Medicare will cover some dental services if they are required to protect general health, or  if they are necessary to another health service that Medicare covers to be successful. For example:

  • An oral examination given in the hospital because prior to a kidney transplant or in a rural or federally qualified health clinic before a heart valve replacement;
  • You have a disease that involves the jaw (like oral cancer) and need dental services that are necessary for radiation treatment;
  • You had a facial tumor removed and had ridge reconstruction (reconstruction of part of the jaw) as part of that procedure;
  • You need surgery to treat fractures of the jaw or face;
  • You need dental splints and wiring as a result of jaw surgery.

However, once the underlying medical condition has been treated,  Medicare will not pay for any more follow-up dental care.   For example, if Medicare paid for a tooth to be removed as part of surgery to repair a facial injury from a car accident, it will not pay for any other dental care you may need later because you had the tooth removed.

In addition, Medicare will pay for some dental-related hospitalizations, for example, if  you develop an infection after having a tooth pulled, or if you require observation during a dental procedure because you have another health-threatening condition. In this case, Medicare will cover its usual cost of hospitalization (including room and board, anesthesia, and x-rays), but it will not cover the dentist fee for treatment or fees for other physicians, such as radiologists or anesthesiologists.

Thanks to Steve Laughary of  Mobile Dentistry of Arizona, www.MobileDentistryofAZ.com, for this information.

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