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Original Medicare doesn’t pay for dentures or related dental appointments for fittings or tooth extractions. To get some coverage of these substantial costs, you’ll need to enroll in Medicare Advantage or private dental insurance.
Medicare excludes all dental services, except in some specific and unusual circumstances where dentistry or oral surgery is required in a broader plan of medical treatment. But dentures are never covered.
There are different types of dentures
Before you consider whether to get dental coverage through Medicare Advantage or a private insurer, it helps to understand a few basics about dentures.
Partial versus full dentures: Partial dentures are recommended when you have enough healthy teeth in the correct positions to anchor a dental appliance. Full dentures replace all upper and/or lower teeth.
Removable versus implant dentures: You take out removable dentures each night to clean them. Implant dentures are installed permanently with surgery that embeds them in your jaw. Removable dentures are typically much less expensive than implant dentures. (Implant dentures are different from dental implants, which replace just one tooth at a time.)
Ask a dentist or prosthodontist (a specialist in replacing missing teeth) to evaluate your potential need for dentures and to estimate the cost, which will help you decide on a Medicare Advantage plan or private dental insurance.
What Medicare Advantage may cover
Most Medicare Advantage plans include some dental coverage. But premiums and coverage limits for dentures and other dental services vary widely, so shop around.
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Consider the amount of coverage for the specific dentures you’ll need, as well as other aspects of the plan’s dental coverage, such as the annual maximum benefit. If you have a preferred dentist or prosthodontist, make sure they’re in your Medicare Advantage plan’s network.
What private or group dental insurance may cover
Especially if Original Medicare provides all the care you need except for dental, you may want to consider private dental insurance instead of Medicare Advantage.
As with Medicare Advantage, premiums and benefits for stand-alone dental insurance span a wide range, so it pays to look at the offerings of multiple insurers. If you have a preferred dentist or prosthodontist, make sure they’re in your private dental insurance’s network.
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Finally, if you or your spouse is still working, you may be eligible for group dental insurance through the employer. Just be sure the plan’s coverage for dentures meets your needs.
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John Rossheim writes for NerdWallet. Email: USexpansion@nerdwallet.com.
