When Americans age into the Medicare system, they are often surprised to learn that Original Medicare lacks dental coverage. Original Medicare is a phrase used to describe Medicare Parts A and B that cover hospitalization and medical care. Original Medicare allows enrollees to use any doctor or hospital who accepts Medicare but Original Medicare lacks certain health benefits such as coverage for dental treatments (as well as coverage for many vision and hearing issues).
An absence of dental coverage is dangerous for seniors’ oral health since, as people age they are more likely to develop medical conditions requiring ongoing medication. These medications, in turn, can sometimes produce side effects that include "dry mouth." For example, dry mouth, otherwise known as xerostomia, can be caused by medications such as antihistamines, decongestants and some antidepressants.
Dry mouth, unfortunately, can contribute to tooth decay in the elderly since saliva helps protect teeth against cavities. When the mouth is dry, this saliva protection against cavities is gone. The cavities that happen because of dry mouth may increase in severity and lead to tooth loss. This, in response, can lead to an unhealthy diet as the Dimensions of Dental Hygiene explains below:
“Progressive tooth loss, culminating in edentulism, impairs biting and chewing, leading to inadequate intake of essential nutrients. This often results in unintentional weight changes and increased malnutrition risk. Older adults with compromised dentition may avoid nutrient-dense foods high in fiber, such as fruits, vegetables, nuts, and grains, due to difficulty in chewing, leading to weight loss and muscle mass reduction. Simultaneously, a shift toward easier-to-chew, calorie-dense foods can result in weight gain and obesity.” Dimensions of Dental Hygiene
Without dental coverage, seniors are responsible for 100 percent of the cost of dental care and some may delay regular visits for teeth cleanings and x-rays in order to reduce dentistry costs. Worse yet, very expensive treatments such as crowns ($500-$1,500) or dental implants ($4,000-$6,000) may go untreated.
Even though both Original Medicare and traditional Medigap lack dental benefits, there are still other options available for seniors. These options include:
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Private dental insurance refers to a dental plan that was purchased by an individual instead of an employer. Seniors have lots of flexibility when purchasing a private dental plan. They can choose plans based on factors such as:
Private dental insurance for an individual may start as low as $20 a month. Some plans, with very broad benefits and wide dental networks can cost significantly more but still fit within the budget of a senior on a fixed income. There are many private dental plans that cover:
For more information on private dental insurance, see our guide Dental Insurance 101.
For seniors already enrolled in Medicare Advantage, they likely have some form of dental benefits. Over 9-in-10 Medicare Advantage plans have some form of dental coverage. The journal HealthAffairs, however, has noticed that the use of Medicare Advantage supplement benefits can be quite low. In an article, it was observed, "… utilization rates can be quite low. For example, many plans offer limited dental benefits in the form of vouchers, but it can be very difficult for beneficiaries to find dentists that will take vouchers (emphasis added), and plans shared verbally this resulted in utilization rates often lower than 25%."
Given some dentists’ rejection of Medicare Advantage vouchers, it is important to confirm your dentist’s acceptance of such a voucher before you receive a dental service you be paid for by this method.
There are dental schools that offer dental services to the public for reduced costs or, in some cases, for free. Dental care received at a dental school would normally be performed by a student under the guidance of an experienced and licensed dentist. Seniors wishing to use such services must wait for clinic hours and all dental services might not be provided. Additionally, many seniors live in regions that do not have a nearby dental school.
Dental discount plans are not dental insurance plans. Instead, they are non-insurance dental plans where an enrollee pays an annual fee for access to a dentist network where procedures are delivered with a discount off of retail price. Care received by nonparticipating dentists is paid at full price with no discounts.
Our knowledgeable customer service team will assist you with any questions you may have prior to enrolling in a dental plan. They can guide you through the process of choosing coverage that matches your needs as well as your budget.
