Does Medicare cover dental care for senior citizens?
Are you taking care of your dental health and scheduling regular exams, x-rays, and cleanings?
According to the 2022 Kansas Oral Health Report, approximately two-thirds of Kansas adults visit the dentist, and one-third of older adults have lost six or more teeth due to tooth decay or gum disease.
If you’re overdue for a trip to the dentist, you are probably interested in finding dental plans for seniors on Medicare.
How Medicare helps pay for dental care
Are you wondering which Medicare plans have dental care and which ones do not? Here’s a quick summary.
Original Medicare
Original Medicare doesn’t provide preventative dental care services but may cover certain emergency services when deemed medically necessary.
Key dates to remember: Annual Enrollment Period (AEP) runs from October 15 through December 7. During AEP, you can:
- Switch from Original Medicare to a Medicare Advantage (MA) plan
- Switch from one MA plan to another MA plan
- Change from MA back to an Original Medicare plan
- Join a Medicare drug plan
- Switch from one Medicare drug plan to another
Coverage for any changes made during this time starts on January 1.
Medicare Advantage
You can check for and switch to a Medicare Advantage Plan C that offers dental and other benefits.
Medicare Advantage Open Enrollment Period (OEP) runs from January 1 through March 31. During OEP, you can:
- Drop your MA plan and return to Original Medicare
- Switch from one MA plan to another MA plan
Medicare Supplement AKA Medigap
As with Original Medicare, Medicare Supplement plans, AKA Medigap, don’t cover dental services.
Other ways to save on dental care
Another way to save on dental care is to shop for a stand-alone dental insurance plan. Individual and family dental insurance plans from Blue Cross and Blue Shield of Kansas typically provide a base level of coverage for certain preventive services, such as two cleanings and annual oral exams. Additional services for procedures like root canals, fillings, or extractions are provided on a discount basis up to the plan’s maximum annual allowance.
Other potential ways to save on dental care:
- Research dental clinics or dental schools near you that offer free or reduced costs
- Ask your dentist for a cash discount
- Set up a payment plan
- Shop around for the best dental care rates
And although you can no longer contribute to a health savings account once you enroll in Medicare, you may withdraw money from your HSA and use these pre-tax dollars to help pay for certain dental expenses.
Emergency dental care services
While Medicare doesn’t cover routine dental care, there are certain instances when limited Medicare coverage for dental health may be possible.
Medicare-covered emergency dental care may include:
- Wiring or splints needed to repair a broken jaw
- Tooth extraction needed after an accident
- Emergency surgery to treat face fractures
- Oral exam prior to kidney transplant
- Oral exam prior to heart valve replacement
According to the Medicare Rights Center, these dental care services must be deemed necessary “to protect your general health, or for dental care needed in order for another Medicare-covered health service to be successful.”
Seniors are at risk of dental health problems
The growing problem of poor oral health among seniors results from a lack of coverage. The Kaiser Family Foundation reported that around 24 million Medicare recipients lack coverage for dental care services. And nearly half, or 47 percent, of these beneficiaries have not visited the dentist within the past year.
The most common oral problems seniors have
People risk developing certain dental conditions as they age, such as excessive tooth wear or untreated tooth decay.
Common senior dental health problems include:
- Periodontitis: gum disease
- Dental caries: cavities
- Xerostomia: dry mouth
- Edentulism: tooth loss
- Oral cancer
Drinking more water throughout the day may help relieve a dry mouth, as will over-the-counter mouth moisturizers. Also, certain prescription drugs may contribute to dry mouth. You may want to check with your healthcare provider to see if you need to change medications or dosage.
Other conditions resulting from poor oral health and hygiene
Regular cleanings and exams ensure you keep up with any potential oral health problems as they develop. Left unchecked improper oral hygiene can lead to a build-up of bacteria and a general decline in overall health and wellness.
Poor oral health has been linked to certain inflammatory diseases such as endocarditis, an infection of the heart’s inner lining. Left untreated, poor oral health habits also increase the risk of developing chronic disease conditions such as cancer, heart problems, or respiratory disease.
Signs of poor oral health
This may indicate underlying dental problems if you experience a sudden sensitivity to either hot or cold beverages or pain while chewing.
Look for specific signals that are signs of poor oral health, such as:
- Aching teeth
- Receding gums
- Loose teeth
- Missing teeth
- Chronic bad breath
Also, watch for any bleeding gums after flossing or brushing your teeth.
Oral hygiene tips
A regular dental care routine is key to keeping your teeth and gums healthy now and in the future.
Here are some critical oral hygiene tips to follow to keep your smile in top condition:
- Floss your teeth once a day
- Brush your teeth at least two times every day
- Brush your tongue every time you brush your teeth
- Limit your intake of sugary foods and drink
- Stay away from cigarettes and other tobacco products
And the number one tip for maintaining healthy teeth is keeping up with routine dental care to help eliminate plaque build-up. At a minimum, you should go in for a professional cleaning annually. But, depending on our oral health history, your dentist may recommend more frequent visits.
Denture care tips
Dentures require routine care to keep them looking their best. You should clean your dentures at least once a day. This includes removing them, cleaning with a soft toothbrush, and soaking them overnight in a denture cleaning solution. And don’t forget to thoroughly rinse off your dentures before putting them back in your mouth.
Anyone wearing full or partial dentures should avoid hard-to-eat food that may put undue stress on your gums and dentures. This includes tough meats, corn on the cob, carrot sticks, whole apples, and hard nuts.
You should also take the time to clean your mouth after you’ve removed your dentures. This includes brushing any remaining teeth along with your tongue and gums. And finally, ask your dentist how often they recommend scheduling regular dental checkups to ensure your dentures are still fitting correctly and you haven’t developed any oral health issues.
Caring for your implants
If you are only missing a small number of teeth, you might not need partial or full dentures. You may be a good candidate for dental implants.
Similar to dentures, you’ll also want to avoid small hard foods that could potentially get stuck in between or underneath the implants. These items could irritate your gums, including celery seeds, sesame seeds, poppy seeds, caraway seeds, and popcorn kernels.
Suggestions on what to eat when you have implants:
- Substitute slow-cooked meats like pulled pork for harder-to-chew pork chops
- Use ground meat in stews in place of large beef chunks
- Indulge in applesauce instead of whole apples
- Crunchy vegetables like carrots, cauliflower, and broccoli are easier to eat when steamed vs. raw
After dental implants, you may also want to avoid all sticky foods like gummy candies, caramels, and peanut butter. Implants can stain just like regular teeth, so avoiding darkly covered beverages like red wine, tea, coffee, or dark beers is best.
Dental Care FAQ
Get answers to your most pressing Medicare dental care questions.
Does Medicare cover dental implants for seniors?
Although original Medicare doesn’t provide coverage for dental implants, you can switch to a Medicare Advantage plan that includes dental benefits. However, if any medical complications arise due to implant surgery, Medicare will cover those costs.
Does Medicare have dental insurance for seniors?
While Original Medicare doesn’t cover routine dental services, a Medicare Advantage plan (Part C) may offer additional benefits such as routine cleanings and exams. In a dental emergency, Medicare Part A would cover any procedures requiring a hospital stay.
Where can you get dental insurance for seniors on Medicare?
The top places to look for dental insurance:
- Medicare Advantage plan that includes dental benefits
- Stand-alone dental insurance plan
- Enroll in a dental discount plan
If your spouse is still working and the employer health plan includes dental insurance, check to see if you qualify for family coverage.
What is the best dental insurance for you?
At Blue Cross and Blue Shield of Kansas, we can help you find the best dental insurance for you when you’re on Medicare. Call us today and speak with one of our reps who can help you find a Medicare plan that includes dental benefits.