Dentures are covered under Medicare Advantage plans or Medicare Part C. Medicare Advantage plans are supplements to traditional Medicare plans, known as Medicare Parts A and B. These supplemental plans are optional and open to seniors aged 65 and older, as well as those with a qualifying disability.
Most Medicare Part C plans cover basic dental care, such as exams, cleaning and fillings and more extensive procedures, such as root canals, tooth extractions, crowns and dentures. Because these plans are sold through private insurance companies, the types of coverage can vary. Seniors should research what each available plan covers before deciding on one. Applicants may also wish to have a dental exam and ask for advice when choosing a plan — the dentist may see a need for additional service coverage down the line, so having a plan that will cover future services is important.
There are two types of dentures. Removable dentures are available in either a complete set of teeth or partial dentures, which cover gaps in the mouth. Implant dentures are surgically implanted in the jaw, with a titanium root and a cap that screws on top.
Medicare Advantage plans may cover both kinds of dentures or only one. Most applicants are advised to talk to a dentist who can determine which type of dentures are best for the individual and offer guidance toward the right plan.
Many plans have a limit on the services they provide. For example, coverage may be limited to a cleaning every six months and one set of dental x-rays per year. Most plans have a maximum dental coverage amount per year, typically between $1,000 and $2,000.
The average premium is approximately $35 per month or $420 per year. Medicare Advantage plans also require a co-pay for doctor visits and services; the average co-pay is $45 per visit.
Most Medicare Advantage plans require you to visit in-network providers.
Medicare Part C is sold through private insurance companies. Enrollment in Traditional Medicare is a prerequisite for purchasing Medicare Advantage plans. Then, applicants can get quotes from supplemental Medicare providers in their area. Bear in mind that supplemental providers don’t cover all areas of the country, so it’s important to find ones that cover the correct location. For those who split their time between two locations, it’s a good idea to look for plans that cover both areas or enroll in plans from providers in both locations.
Supplemental Medicare plans don’t have open enrollment periods like traditional Medicare does. Those eligible can sign up for plans at any time.
Use Medicare’s Plan Finder to locate supplemental plans in the desired area. Some applicants may be able to sign up online through the plan’s website. If that is not possible, they can contact the plan provider for a paper enrollment form, fill it out and return it to the plan provider. All plans offer a paper enrollment option. The plan’s provider will ask for a Medicare number and the date the Part A or Part B coverage started, which is found on the Medicaid card.
Once an individual finds a suitable plan, they can call the provider for more information. Those with more general questions can call Medicare at 1-800-MEDICARE (1-800-633-4227).
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