Medicare Supplemental Dental Insurance Coverage and Benefits

Medicare Supplemental Dental Insurance

Medicare Supplemental Dental Insurance provides benefits for those with more than 65 years of age or older, those with chronic kidney disease, and those with disabilities.

The Coverage

Dentists rate the oral health benefits in Medicare as none because they are limited to the services for medical needs including the dental exam for kidney transplantation, heart valve replacement or extractions as the preparation for the radiation treatment including the jaw or jaw reconstruction caused accidental injury.

They do not cover any dental care or other dental procedures such as dentures, tooth extractions, fillings, and cleanings.

It was in 2003; Medicare created the incentives for Medicare managed plans to provide enhanced dental benefits.

It means they pay some dentistry-related hospitalizations. In another word, if you get an infection after a tooth pulled, or if you need observation during the dental procedure since you have health-threatening condition, they can help you. In this case, they can cover the cost of hospitalization including the fee for your dentist treatment. However, they cannot cover the dental care specifically excluded from the Original Medicare although you are lying on a bed in a hospital.

The coverage is available in two types. The first is a hospital insurance program. To use this program, you must be eligible. You can enroll without paying the fee. The Social Security should cover you, or if not you must pay the premium. It is because when you are participating in the Social Security, you are automatically joining for Medicare. If you apply for Medicare, you cannot be the member of Social Security automatically.

The second type is a medical insurance program covering charges from surgeons, doctors, and other outpatient providers including the fees for the medical supplies. If you are eligible for the first type, you can choose the supplemental coverage in this option. However, you need a monthly premium to pay if you want to get this advantage.

If you want to enroll in Medicare, you do not have to retire. The eligible participants are starting from age 65. When you join the Medicare, you qualify for the first and the second program. If you keep working after 65, you need to sign up for the first program above. If you have the health coverage through your union or employer, the first program is still helpful to pay some expenses that your group health plan cannot cover.

You can sign up for the second option if your spouse is working with the group health coverage through your spouse’s employer or union. In this condition, you must pay Medicare premium for the second program monthly, and the benefits are limited as long as the group health plan is still the payer for the medical bills you have.

The Dental Advantage Plans

Medicare Supplemental Dental Insurance is available at low, no cost for eligible seniors who join Medicare-sanctioned, the fee-for-service plan regulated by the state to provide dental and medical assistance. It is also known as the Medicare Advantage plans that run by private health insurers. Doctor and hospital are not required to accept the plan’s term and condition; you can choose the treatment under emergency conditions.

Reference: Medicare.gov

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