Does Medicare Cover Dental Treatments?

Medicare is a type of health insurance that typically provides coverage for patients over the age of 65 who require medically necessary procedures. Medicare does not provide coverage for general dentistry procedures such as routine cleanings and exams or dental fillings; however, if you are suffering from infection or another condition that is impacting both your oral and physical health (including bone loss or pain while chewing), Medicare may cover a portion of your out-of-pocket costs. Dr. Joe McIntyre at Smiles for Life Dental Care is one of only one percent of U.S. dentists who are certified to treat Medicare patients. He can conduct a thorough examination at our Bridgewater, VA, practice and determine whether your oral health needs require medically necessary intervention.

Medically Necessary Dental Services

There are a number of Medicare insurance plans available to patients in the state of Virginia, but not every plan will provide coverage for dental services. If you have a condition that, if left untreated, would impact your health and well-being, you may be eligible to have a portion of your costs covered by Medicare. Generally speaking, only severe oral health conditions that threaten your overall physical health are considered medically necessary procedures. These conditions could include:

  • Dental infection that is threatening your physical health and increasing your risk for heart disease, heart attack, stroke, pulmonary (lung) infection, or blood clots
  • Gastroesophageal reflux or other stomach issues that result from a poor diet due to an inability to chew or consume healthy foods
  • Cysts or abscesses in the bone
  • Difficulty chewing food due to pain and lack of teeth

To determine whether you qualify to have your dental services covered by Medicare, you must visit our office in person for a consultation. Dr. McIntyre can perform an examination and evaluate your condition to determine whether it meets medical necessity requirements.

If you have a condition that, if left untreated, would impact your well-being, you may be eligible to have a portion of your costs covered by Medicare.

Your Out-of-Pocket Costs

Even if Medicare determines that you have a condition requiring medical intervention, you will still be responsible for the remaining cost of treatment. While Medicare will not cover all of the fees needed for treatment, under specific conditions, 20 to 30 percent of your costs could be paid. This could translate to having up to $8,000 of your oral surgery treatment covered.

We work with third-party lending companies such as LendingClub, CareCredit, and iCare to help our patients afford the cost of these necessary dental treatments. In addition, we accept all major credit cards, cash, and checks.

Working with You to Maximize Your Coverage

At Smiles for Life Dental Care, we believe that cost should not prohibit you from receiving the dental care you need. If you have Medicare, we will work with you to help maximize your coverage. To schedule your consultation with Dr. McIntyre, contact our office online. You can also call our office at (540) 828-2312 to speak with a member of our staff about any questions you may have about Medicare and dental care.