Dental Coverage for Retirees
Getting dental care is at least as important when you’re older as when you’re younger, and maybe more so. Past dental problems may require additional treatment over time, such as when a filling becomes broken or chipped. Risks for tooth loss as a result of tooth decay and gum disease grow with age, because of many factors. For example, you may have decreased saliva production (dry mouth) from medications taken to treat medical conditions. And, chronic diseases such as diabetes may increase the risk of gum disease. Cognitive or physical limits may make routine brushing and flossing harder, which can get in the way of keeping your teeth healthy.
Dental insurance can help make sure you can afford the dental care you need as you get older. If you’re working, you may get dental coverage through your employer. But, once you retire, getting dental coverage may not be as easy.
Starting at age 65, Americans can get health insurance from Medicare, a federal government program. Since most people retire around that age, Medicare is often thought of as health insurance for retirees. (Actually, some people on Medicare keep working, and Medicare also covers disabled people and people with end-stage renal disease.) But, except as described below, Medicare doesn’t cover most dental services. So, if retirees want dental insurance, they have to look elsewhere.
Some retirees have dental insurance through a prior employer—retiree dental coverage paid by the employer or an employee fund—though this is not common. And, it has only been relatively recently that options existed for older Americans to obtain dental coverage as individuals.
This guide will tell you:
- What kinds of dental care Medicare does and doesn’t cover; and
- Where you can find dental coverage other than Medicare.
Dental Care Covered by Medicare
Medicare covers dental care only when it’s deemed medically necessary. An example is pulling teeth after an injury, or treating fractured jaws. Medicare Part A (hospital insurance) does cover limited dental services if you receive them in a hospital, and if they’re necessary to help perform a covered, non-dental procedure or medical service. An example is if you have a facial tumor removed and have dental jaw ridge reconstruction as part of that procedure.
But, Medicare doesn’t cover routine dental care such as cleanings, fillings, root canals, implants or dentures. Nor does Medicare cover the follow-up treatment for services covered for medical necessity. For example, Medicare will cover the removal of teeth in preparation for radiation therapy, but not pay any of the costs for replacement of those extracted teeth. If Medicare paid for a tooth to be removed as part of surgery to repair a facial injury you got in a car accident, it will not pay for any other dental care you may need later because you had the tooth removed.