Does Medicare cover the cost of dentures? The quick and easy answer is “no.” The US government’s over-65 health care coverage plan doesn’t do much in the way of dentistry or oral treatments. While some Medicare plans may cover tooth extraction procedures in preparation for advanced surgical procedures, Medicare will not cover implants or dentures if they become necessary after the extraction procedure.
If you’re looking for financial assistance with your dentures, you should first examine private Medicare-approved insurance packages provided by third-party companies. These coverage packages are typically called Medicare Advantage plans. Some of them feature routine dental coverage which may include dentures. Contact a local insurance agent or company and ask them about Advantage plans (sometimes called Medicare Part C).
If you can’t find any routine dental or denture coverage through Medicare Advantage, you can also try Medigap. Medigap is a generic term for third-party health plans that fill the gaps in Medicare’s coverage areas. Finding an appropriate Medigap plan requires a bit of research, much like the Medicare Advantage option does. The good news is that major insurance providers offer a wide range of plans that include everything from annual teeth cleanings to oral screenings to dentures. Medigap plans usually require a monthly payment and a co-pay for certain services. We can help you determine if a plan is right for you!
More options for assistance
Medicaid is another option when it comes to obtaining financial help with your dentures. However, it is restricted to low-income Americans. Medicaid has also experienced a series of funding crises over the years, and it is often difficult to obtain coverage during tough economic times. As a result, the federal government has made various funding changes to the Medicaid program. These changes include cuts to dental coverage. You’ll need to ask your local representative to detail what, if any, dental assistance is currently offered in your state. The Affordable Care Act — also known as Obamacare — changed how Medicaid eligibility is determined. Although eligibility is still based on your adjusted gross income, coverage differs by your state of residence. If you qualify, routine dental care and dentures may be covered by Medicaid in your state.
Health Savings Accounts (HSAs) are another option. However, these are typically obtained through your employer and thus may not be feasible if you’re at or nearing your retirement. They are also regulated by the Internal Revenue Service, and feature annual contribution limits. The IRS determines which expenses will be reimbursed and which will not. HSAs usually allow for denture expense reimbursement as well as teeth cleaning, decay prevention treatments, fillings, braces, extractions, and x-rays. HSAs typically do not allow for unnecessary cosmetic procedures. These accounts function similarly to flexible spending accounts. One difference is that unlike FSAs, HSA balances roll over from year to year if the money is not spent.