Medicare Dental Coverage - Is It Enough?
Most beneficiaries of Medicare often complain that the dental coverage of the service is unsatisfying. In fact, it doesn't really give them much assurance that their dental health will remain intact even in their senior years. Indeed, Medicare dental coverage is quite limited.
What Medicare Doesn't Cover
Medicare generally only covers dental services that are in direct association with a present medical condition. Without the said association, there really isn't anything much that the insurance covers. The following are health needs that are not included in the Medicare dental coverage.
*Routine dental care
*Dental procedures such as: fillings, cleaning, tooth extractions (depends on the situation)
*Dentures
*Dental plates and devices
Since Medicare does not cover these dental services, most beneficiaries find a hard time dealing with their finances while fighting for their severed health condition. For problems like these (wherein Medicare refuses to pay for a dental service although it is needed by the beneficiary) calling the State Health Insurance Assistance Program (SHIP) may help. SHIP will help the beneficiary find dental assistance programs for individuals with a low income in a particular area so that financial assistance may be rendered.
What Medicare Does Cover
Although it's unfortunate that most Medicare beneficiaries wouldn't get enough support for their dental problems, there are specific situations that the Medicare dental coverage does include. The following is an enumeration of the dental services covered by Medicare:
*Oral examinations done in the hospital as part of the routine checklist before undergoing a kidney transplant as well as examinations done in rural or federally qualified health clinics prior to a heart valve replacement
*Ridge reconstructions after a facial tumor was removed
*Surgery for the treatment of jaw or face fractures
*Dental services needed for radiation treatment in cases of cancer that involves the jaw such as oral cancer
*Dental splints and wiring due to injury
On the other hand, it is essential to note that Medicare will only pay for the initial application of these dental services. After the treatment of the underlying disease condition, if there is any follow up dental care needed, Medicare will no longer shoulder it.
Medicare will shoulder these aforementioned dental services whether or not hospitalization is needed. However, there are some situations where hospitalization is needed and good thing, Medicare do shoulder these dental-related hospitalizations such as when you develop an infection after tooth extraction or when you need to be observed closely during a dental procedure since you have a life-threatening condition.
In these two particular hospitalizations, Medicare will shoulder the x-ray fees, anesthesia, and the room and board. However, it will not cover the fee of the dentist and other health practitioners committed to the care of the beneficiary.
On a final note, it is necessary for every beneficiary to understand that one's Medicare Dental coverage is limited because the coverage is not determined based on the necessity of a certain dental procedure but instead, the coverage is determined by the type of dental service to be provided and the anatomical structure wherein the dental procedure is to be performed.
What Medicare Doesn't Cover
Medicare generally only covers dental services that are in direct association with a present medical condition. Without the said association, there really isn't anything much that the insurance covers. The following are health needs that are not included in the Medicare dental coverage.
*Routine dental care
*Dental procedures such as: fillings, cleaning, tooth extractions (depends on the situation)
*Dentures
*Dental plates and devices
Since Medicare does not cover these dental services, most beneficiaries find a hard time dealing with their finances while fighting for their severed health condition. For problems like these (wherein Medicare refuses to pay for a dental service although it is needed by the beneficiary) calling the State Health Insurance Assistance Program (SHIP) may help. SHIP will help the beneficiary find dental assistance programs for individuals with a low income in a particular area so that financial assistance may be rendered.
What Medicare Does Cover
Although it's unfortunate that most Medicare beneficiaries wouldn't get enough support for their dental problems, there are specific situations that the Medicare dental coverage does include. The following is an enumeration of the dental services covered by Medicare:
*Oral examinations done in the hospital as part of the routine checklist before undergoing a kidney transplant as well as examinations done in rural or federally qualified health clinics prior to a heart valve replacement
*Ridge reconstructions after a facial tumor was removed
*Surgery for the treatment of jaw or face fractures
*Dental services needed for radiation treatment in cases of cancer that involves the jaw such as oral cancer
*Dental splints and wiring due to injury
On the other hand, it is essential to note that Medicare will only pay for the initial application of these dental services. After the treatment of the underlying disease condition, if there is any follow up dental care needed, Medicare will no longer shoulder it.
Medicare will shoulder these aforementioned dental services whether or not hospitalization is needed. However, there are some situations where hospitalization is needed and good thing, Medicare do shoulder these dental-related hospitalizations such as when you develop an infection after tooth extraction or when you need to be observed closely during a dental procedure since you have a life-threatening condition.
In these two particular hospitalizations, Medicare will shoulder the x-ray fees, anesthesia, and the room and board. However, it will not cover the fee of the dentist and other health practitioners committed to the care of the beneficiary.
On a final note, it is necessary for every beneficiary to understand that one's Medicare Dental coverage is limited because the coverage is not determined based on the necessity of a certain dental procedure but instead, the coverage is determined by the type of dental service to be provided and the anatomical structure wherein the dental procedure is to be performed.
