Medicare generally covers hospital stays, visits to a physician, and certain medicines. It does not, however, ordinarily cover dental care. There are a few exceptions to this general rule though.
Medicare Part A will pay for certain dental services that you get when you’re in a hospital (such as an emergency or complicated dental procedure), but it typically doesn’t cover routine checkups, cleanings, fillings, dentures, or implants. For example, if you have a tooth (or teeth) pulled in preparation for a medical procedure and Medicare pays for this procedure, you will still be responsible for covering the cost of implants, if you want them afterwards.
Also, Medicare will pay for certain dental services that are needed to maintain your general health, but implants don’t usually fall into this category. For example, the following are a few situations when Medicare will likely pay for dental services.
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- You get an oral exam in the hospital because you will be getting a kidney transplant. (Tooth decay and gum disease sometimes lead to infections that can cause problems for those with kidney issues.)
- You have a particular condition that involves the jaw (such as oral cancer) and dental services are necessary for treatment.
- You have a facial tumor that will be removed and need ridge reconstruction (reconstruction of part of the jaw) as part of that procedure.
- You have fractures to your jaw or face and need surgery.
- You had jaw surgery and need dental splints and wiring.
Medicare will also cover certain dental-related hospitalizations, such as if you get an infection after a tooth is pulled.
Still, even if Medicare covers these dental services, it will not pay for follow-up dental care once the underlying health condition has been treated. For example, say Medicare paid for your tooth to be extracted as part of surgery to repair a jaw injury you sustained in a car accident. Medicare will generally not cover further dental care you may need afterwards because the tooth was removed. This means Medicare will not pay for an implant.
On the other hand, some private Medicare health plans (such as Medicare Advantage Plans) offer dental coverage. If you have a Medicare health plan and want to find out if you have dental coverage, check with your plan to find out which services are covered.
In addition, if you don’t have dental coverage through Medicare, you may want to investigate opportunities for free or reduced dental care offered by hospitals, community health centers, and/or dental schools in your area.