Medicare and Dental Implants

January 11, 2023

The answer, at the moment, is sometimes. Original Medicare does not provide coverage for dental implants. However, some Medicare Advantage plans do offer coverage for portions of a dental implant procedure.

Now, nearly half of all Medicare beneficiaries, almost 24 million individuals, don’t have dental coverage with their Medicare plans according to the Kaiser Family Foundation. Proposed legislation aims to change that with some lawmakers hoping to add dental coverage to Medicare. This is something that would be a huge plus for the 62.7 million people enrolled in Medicare for their primary health coverage.

For now, here’s what to know about how those enrolled in Medicare can potentially benefit to cover a portion of implant costs.

  • Medicare Part A, which covers hospital stays, skilled nursing care facilities and hospice does cover certain medical dental services during a hospital stay. This can include repair work to your teeth or jaw due to traumatic injuries. Typically, Medicare covers hospitalization and procedures medically necessary for a patient’s recovery.
  • The most coverage for dental implants you will find with Medicare comes from Medicare Advantage plans. Some Medicare Advantage plans do provide dental benefits for policyholders which can include coverage for dental implants.
  • To receive this extra Medicare Advantage benefit, you may pay a higher monthly premium, but you will need to keep in mind the maximum dental benefit under your specific plan.
  • Medicare Advantage plans almost always require copayments and deductibles for dental services. On most plans, you will be responsible for 100% of the cost after you meet the plan’s maximum benefit.

When choosing a Medicare Advantage plan to cover dental implants, you want to first be sure your plan offers dental coverage. Secondly, ensure the plan covers dental implants as well. Some Medicare Advantage plans with dental coverage can explicitly exclude dental implant coverage. To verify coverage eligibility, you will need to review the plan’s Evidence of Coverage.

Either way, the team at Lakeside can help you navigate through a payment option that will fit your budget. We have a variety of financing options including a partnership with Michigan Schools & Government Credit Union that can get you the best available rates.