Dental Plans for Seniors on Medicare: Your Options Compared

If you're on Original Medicare, you've probably noticed that routine dental care isn't covered. Medicare only pays for dental services in limited situations, for example when they're closely tied to certain covered medical treatments. For cleanings, fillings, dentures and implants, seniors usually need another source of coverage. Here are the main options.

1. Medicare Advantage plans with dental

Many Medicare Advantage (Part C) plans include dental benefits, usually preventive care and sometimes major services. They can be good value if you need a plan anyway, but check the annual dental maximum, the network and whether comprehensive care costs extra.

2. Standalone dental insurance

You can buy a dental policy on its own and keep Original Medicare. These plans typically cover preventive care at a high percentage, basic services at a lower one, and major services such as crowns or dentures at around half, up to an annual maximum. Expect waiting periods for major work, often six to twelve months.

For many people on Original Medicare this is the simplest fix: you keep the coverage you already have, you can enroll any time of year rather than waiting for the fall enrollment window, and the dental benefit isn't tied to a medical plan's network. When comparing policies, look at the annual maximum, the waiting period for major work and whether dentures and implants are covered at all. Here are some of the plans available to seniors:

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3. Dental discount plans

Discount plans are not insurance. You pay a yearly membership fee and get reduced prices from participating dentists. There are usually no waiting periods or annual maximums, which can make them useful if you need work done soon. Savings depend on the plan and the dentist, so compare the fee schedule with the prices you'd otherwise pay.

4. Medicaid, PACE and veterans' benefits

If you qualify for both Medicare and Medicaid, your state Medicaid program may cover some adult dental care; benefits vary by state. PACE programs (Programs of All-Inclusive Care for the Elderly) include dental care for enrollees. Eligible veterans may get dental care through the VA or can buy coverage through the VA Dental Insurance Program.

How to pick the right option

• Mostly need checkups? A Medicare Advantage plan with preventive dental, or a low-cost standalone plan, is often enough.
• Expect major work soon? Look at waiting periods and annual maximums first. A discount plan may help in the short term.
• Have a dentist you like? Confirm they're in network before you enroll.

The Medicare Annual Enrollment Period runs from October 15 to December 7, which is a good time to compare Medicare Advantage plans. Standalone dental and discount plans can usually be bought any time of year.

Quick Answers

Does Original Medicare ever pay for dental care?

Only in limited cases, when the dental service is closely tied to certain covered medical treatments. Routine care such as cleanings, fillings, dentures and implants isn't covered.

Can I have dental insurance and a discount plan at the same time?

Generally, yes. Some people keep a discount plan for services their insurance doesn't cover, or to use during a waiting period. Check how each one applies at your dentist before you book.