By Jenny Austin-Krzemien, Certified Concierge Care Advisor
Medicare and Dental Care: What Seniors Need to Know About Coverage Gap
My parents have had so many dental issues since they retired, and it is appalling how much they have had to pay for their care. I was shocked to find out that Medicare dental coverage does not include basic dental care.
Dental health is one of the keys to healthy aging. Poor dental health can lead to serious health issues. For example, when a person cannot chew properly, it can result in malnutrition. Furthermore, bacteria from gum infections can enter the bloodstream, raising the risk of heart disease.
Does Medicare Cover Dental Care?
Traditional Medicare coverage does NOT cover routine dental services such as exams, cleanings, or X-rays—nor more expensive procedures like fillings, crowns, or dentures. Dental insurance must be paid for separately. According to U.S. News, over 51% of older adults on Medicare lack dental insurance, leaving them vulnerable to high out-of-pocket expenses.
Nursing homes across the country are seeing significant dental health issues among residents. Nearly 20% of nursing home residents have missing teeth, 8% have broken teeth or cavities, and 11% report pain while chewing, according to the same U.S. News research. Preventative care is necessary for oral health and can significantly reduce the occurrence of tooth decay and gum disease in seniors.
Why Medicare Doesn’t Include Dental Coverage
When Medicare was established in 1965, dental care wasn’t prioritized in the program’s design. As RetireGuide explains, there have been efforts to add dental benefits to Medicare, but the American Dental Association (ADA) opposes these proposals due to concerns over potential reimbursement cuts. To integrate dental care as part of primary health care, Medicare would need increased funding, government support, and an expanded healthcare workforce.
Options for Senior Dental Insurance
While Medicare Advantage plans often include basic dental coverage, traditional Medicare does not. Seniors may need to purchase private dental insurance/ dental plans or explore Medicaid options if they qualify based on income. It’s essential for seniors to be proactive in finding affordable dental care to avoid health complications and reduce the need for extensive dental procedures down the road.
We Can Help
At Concierge Care Advisors, we help families navigate healthcare options, including identifying the best dental insurance plans for seniors. Contact us today for a free consultation to explore personalized solutions for your family.
