Medicare Coverage & Dentures
Understanding Your Options for Original Medicare, Medicare Advantage, & Private Insurance
The loss of teeth is more likely as we age. According to the Centers for Disease Control, almost one-in-five seniors have lost all of their teeth. There are a variety of factors contributing to tooth loss among the elderly, ranging from poor oral health or mouth injuries to medications that cause dry mouth and its ensuing problems for the teeth and gums. If you a senior citizen suffering from tooth loss, this article will:
- Briefly summarize denture options
- The cost of dentures
- Review dental coverage in Original Medicare
- Review dental coverage in Medicare Advantage
- Review dental coverage in private insurance options for individuals
Dentures are artificial teeth used in the space previously occupied by a person’s natural teeth and now empty due to tooth loss. Dentures are made from various materials such as acrylic plastic or porcelain. Dentures may be designed to be removable for cleaning or to be fixed in place within a person’s mouth. There are two main types of dentures:
- Partial denture
- Complete dentures (otherwise known as “full dentures”)
A partial denture is used for conditions where some teeth in the mouth are missing and others are still present. A partial denture may use the remaining natural teeth as a means to help anchor itself appropriately in the jaw.
A complete denture refers to artificial teeth that fit over the gums in a toothless upper or lower jaw.
The Cost of Complete & Partial Dentures
According to price ranges provided by Aspen Dental, the cost for complete dentures is listed between $1,649 and $2,219. Acrylic partial dentures, in contrast, are less expensive, estimated to be between $769 and $1,079.
Many factors affect the cost of dentures including the denture material and whether the denture is fixed in place or removable. Dentures secured in the mouth through implants can be quite expensive, with GoodRx estimating the average cost at $21,500.
Original Medicare & Dentures
Original Medicare refers to Medicare Part A, which covers hospitalization, and Part B, which covers medical services. In general, Original Medicare will not pay for standard dental care such as cleanings, fillings, crowns, etc. The exception to this are some forms of emergency dental care received in a hospital. Dentures would not qualify for this condition.
Medicare Advantage & Denture Coverage
Medicare Advantage is a private insurance plan that delivers the coverage of Original Medicare, most often delivered within the context of a health care provider network. Medicare Advantage plans may provide benefits not included in Original Medicare, such as prescription drug coverage.
Over 90 percent of Medicare Advantage plans include some form of dental coverage. However, the dental coverage is not standardized. In other words, the dental services covered varies from one Medicare Advantage plan to another. There are Medicare Advantage plans on the market that include coverage for dentures. A senior looking for denture coverage through Medicare Advantage should review a plan’s Summary of Benefits to 1) confirm whether denture coverage is provided, and 2) what conditions are placed on the coverage (e.g. out-of-pocket obligations, years before a replacement may be covered, etc.).
Denture Coverage within Private Insurance
Denture coverage varies among private dental insurance plans. “Private dental insurance” refers to insurance purchased by a consumer, as opposed to a group plan purchased by a company or union. DentalInsurance.com is an example of a private dental insurance broker.
Below are some examples of private dental insurance plans that offer denture coverage. You can visit the link to review the specifics of the coverage.
- Delta Dental Immediate Coverage Plan
- NCD Nationwide 3000 Plan
- MetLife TakeAlong Dental HMO-Managed Care 245 (High)
- Renaissance Max Choice Plus
- Anthem BlueCross Essential Choice Incentive
- Delta Dental Dental for Everyone Diamond
- Ameritas Hollywood Smile Premier 2500
Review Denture Coverage in Your Area
Interested in what plans cover dentures in your region and how much they cost? The following link will provide dental insurance quotes for plans offered within your zip code.