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Dental Care for Seniors with Medicare: What you should know

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You’re 65 and just received your Medicare card. You have an aching tooth and need to have the cavity filled. As luck would have it, your dentist can see you today. Dental care for seniors is always covered under Medicare, right?


Medicare doesn’t cover every expense. In fact, most dental care is not covered. Only dental care related to in-patient hospital care is covered under Medicare. For example, extractions done in preparation for radiation treatment for tumors involving the jaw would be covered. Medicare would also make payment for oral exams (but not treatment) preceding a kidney transplant or a heart valve replacement, under certain circumstances.

But most routine and common dental care procedures (preventive cleanings, fillings, crowns, extractions, bridge work, dentures) are not covered. If you need services not covered by Medicare, you need to pay for them yourself unless you have other dental insurance or a Medicare health plan that covers dental care.

For many people, the lack of dental care coverage under Medicare is a surprise. Below are two steps to lessen the burden of your dental expenses in your senior years.

Prior to Getting on Medicare

If you are approaching Medicare eligibility and have dental insurance, use it! Many dentists have an “I don’t fix it if it’s not broken” approach. Other dentists are more proactive. Talk to your dentist about routine procedures, such as fillings or crowns, that may be required in the coming years and whether it might be possible to take care of those procedures early, while you are still on your traditional dental insurance plan. You don’t want to endure unnecessary procedures, but if you have a known cavity that hasn’t been filled because it’s not bothering you yet, maybe this is the time to have it fixed.

Dental Savings Plans

Many Americans on Medicare – some estimates say up to 20 percent – have either delayed or totally foregone dental treatments due to the high cost. But there’s good news – a dental savings plan may be able to help seniors afford dental care.

A dental savings plan is not insurance. It’s an affordable option that operates a bit like a Sam’s Club membership – you pay a membership fee – often $100 to $150 a year, and then, if your dentist is a member of the plan, he or she will offer you discounts on their services, anywhere from 10% to 60% of their usual costs, depending on the dentist and the plan.

Whereas dental insurance plans have caps on how much they will cover in a year – often $1,000 or $1,500 maximum benefit a year – a dental savings plan has no caps. Each time you visit your dentist, you will get the discount, whether the service is an annual cleaning, x-rays, or work on an individual tooth, such as a crown.

There are many dental savings plans to choose from. You will want to make sure your dentist is included in the plan you choose. More information on dental savings plans can be found at www.dentalplans.com.




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Andrea L. Blackwelder, CFP®, ChFC, CDFA® and Joseph D. Clemens, CFP®, EA are the founders and partners of Wisdom Wealth Strategies. Their shared passion is simple: to bring financial empowerment, understanding, and peace-of mind to people who wish to improve their financial future, build wealth for their families, and achieve financial independence. Click here to find out more about how you can work with the Denver Financial Advisors at Wisdom Wealth Strategies.


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