The Medicare insurance program provides coverage for a lot of medical services. This can include coverage for surgeries, lab work, doctor’s visits, vaccinations, retail prescription medications, preventative services, and more.

Even so, there can still be a good amount of confusion among Medicare beneficiaries about what Medicare does or does not cover. One of the most common points of confusion is how Medicare covers dental care, including dental restoration services. So, does Medicare cover dental restoration? The short answer is, most likely, no.

Medicare Basics

When reaching Medicare eligibility, it’s important to know Medicare’s structure so you can have a better understanding of how it does and does not cover dental restoration. But if you’re still in the learning process about Medicare basics, visit Boomer Benefits – Medicare eligibility to help you get started.

Medicare’s coverage is split into four different parts, including Part A, B, C, and D. When it comes to dental coverage, you’ll want to focus on Medicare Part A, and Part B. Part A helps cover fees associated with inpatient hospital stays while Part B is coverage for outpatient care, such as doctor’s appointments, surgeries, lab work, and more.

Part A and Part B can cover dental services under specific circumstances.

Medicare and Dental Care

You may be surprised to learn that Medicare does not cover routine dental services, including cleanings, checkups, fillings, x-rays, and more. Additionally, Medicare generally does not provide coverage for teeth removal or replacement, dentures, dental plates, and more.

Since dental restoration usually includes repairing and replacing teeth, fillings, and other related services, Medicare is not likely to help.

Dental Care Exceptions

Although Medicare does not cover most dental services, there are some exceptions. These exceptions come up when dental care is related to treating another health condition, including cancer and kidney transplants.

For example, Medicare can offer coverage if you need teeth extractions to prepare your jaw for radiation to treat cancer. Regarding kidney transplants, Medicare Part A can provide coverage for oral examinations administered in an inpatient setting if needed before surgery.

Besides these specific situations, Medicare is not likely to cover dental services.

Other Services Medicare Does Not Cover

There are some services that Medicare does not cover, in addition to dental care. The other two most common types of care that Medicare does not cover are hearing and vision services. Like dental care, Medicare will not cover most routine care related to these services, including hearing aids, eye exams, contact lenses, and eyeglasses.

Medically Necessary

Although Medicare does not cover these routine services, it should cover medically necessary hearing and vision services when needed. A service is considered medically necessary when it is needed to treat, monitor, or diagnose a health condition.

For example, Medicare does provide coverage for cataract surgery.

Paying for Dental, Vision, and Hearing Coverage

Since Medicare does not cover most dental care, what are your options? Well, many people choose to enroll in standalone dental, vision, and hearing plans. There are various plans to choose from, so you’ll want to shop around and see which policies might be best for your needs.

Some people also choose to pay for these services on their own without insurance. This can be more cost-effective for people if they do not need these services often. However, each person’s needs are different, so be sure to choose what’s best for you.

Summary

The bottom line is that Medicare is not likely to cover routine dental services, including dental restoration. The same is true for hearing and vision services.

However, Medicare can help cover medically necessary dental treatments to treat, monitor, or diagnose a health condition. Depending on the service, it may fall under Medicare Part A or Part B.

Consider signing up for a standalone insurance policy if you want more comprehensive dental service coverage. If not, consider paying out-of-pocket for routine services if you can.