Understanding Your Medicare Dental Coverage

If you are suffering from a dental issue that is affecting your oral and physical health, your dental treatment may be covered by your Medicare insurance plan. Medicare provides coverage for procedures that are deemed medically necessary, ranging from minor treatment to major surgery. Our team at Smiles for Life Dental Care can conduct a thorough examination to determine if your issue requires necessary intervention and help you navigate your coverage. To ensure our Staunton and Bridgewater, VA, patients understand their dental coverage under Medicare, we have compiled commonly asked questions and answers.

older smiling couple
Medicare covers medically necessary treatments, from minor procedures to major surgery.

How and When Do I Enroll in Medicare?

Enrollment begins three months prior to your 65th birthday and extends for an additional seven months. Those currently receiving Social Security benefits will automatically be enrolled in Medicare at age 65. It is important to note that Original Medicare has two parts: Part A, for hospital coverage, and Part B, for medical coverage.

Will My Medicare Plan Cover Dental Treatments?

Medicare does not cover services like dental fillings, cleanings, dentures, or other dental devices. However, if your oral health condition is deemed a medical necessity, you may be eligible for payment through Medicare. There are multiple Medicare insurance plans in Virginia and not every plan will cover dental services. The best way to find out if you will be covered is to contact our office for a personal consultation. 

Why Should I Continue Undergoing Bi-Annual Checkups If They Are Not Covered by Medicare?

Preventive care is crucial to your oral health and your overall well-being. It is especially important for our oldest patients, who are at higher risk for developing gum disease and oral cancer. Often, conditions such as a dental infection or minor cavities do not present with any signs or symptoms. However, a dental professional can identify these issues early on and perform appropriate treatment before you require more costly and extensive restorative procedures. Timely treatment can not only save you time and money but protect your dental function, and in turn, your quality of life. 

How Do I Know If My Condition Is a Medical Necessity?

The only way to be sure treatment for your condition is a medical necessity is to visit our office. However, there are several conditions that typically fall into this category. The combination of certain medical conditions and dental disease, for example, is often interpreted as a medical necessity. Studies have connected gum disease to life-threatening conditions including heart disease and stroke. In addition, periodontal disease is linked to diabetic control. Patients with both diabetes and gum disease are at a higher risk for tooth loss and diabetic complications and may qualify for treatment.

Will My Full Treatment Be Covered?

In most cases, Medicare only covers a portion of the treatment costs for medically necessary procedures. However, your plan can reduce your out-of-pocket expenses significantly. For special conditions, Medicare sometimes covers 30 to 50 percent of fees. This percentage can translate to up to $10,000 for full mouth reconstruction and implant treatment.

What If My Plan Excludes Dental Services?

Once a year, you are able to change Medicare plans during open enrollment. Some plans, including Medicare Advantage, have additional benefits that cover services like routine dental care and x-rays. Our financial specialist can advise you on which plans will cover dental treatments and how to switch. 

Can Any Dentist Help Me Use My Medicare Insurance?

In the United States, only about one percent of dentists are certified to treat Medicare patients. Dr. Joe McIntyre and Dr. Dan Whiting are some of the few dentists in Virginia who have the credentials to provide treatment under Medicare plans. They not only have a proven history of helping Medicare patients achieve coverage for dental implants treatment, but they also have extensive experience working with senior patients. As a result, he can tailor treatment to your individual needs and lifestyle for the best possible results.

Contact Us to Learn More

The team at Smiles for Life Dental Care is dedicated to helping our patients achieve optimal oral health and dental function as affordably as possible. We are happy to answer any additional questions you have about Medicare. Contact our office online or call us at (540) 828-2312 to find out more about your Medicare dental coverage. 

Dentists at Smiles for Life Dental Care

Smiles for Life Dental Care

The team of highly trained doctors at Smiles for Life wants to help you achieve and maintain a healthy smile for a lifetime. Because we want every patient to have access to the advanced treatments offered at our practice, we accept many insurance and financing options, including: 

  • Medicare 
  • Compassionate Finance™
  • CareCredit®
  • LendingClub®
  • Smile Rewards 

To get started, call our Bridgewater office at (540) 828-2312 or request an appointment online.

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Bridgewater Office

115 Oakwood Dr
Bridgewater, VA 22812

Open Today 7:00am - 5:00pm

Friday by appointment only

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Staunton Office

502 N Coalter St
Staunton, VA 24401

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