Whether your mouth has left you in pain or a state of self-consciousness, professional dental treatments are the only way to restore your smile. However, the costs of your procedures can leave a sour taste. Before looking for a dentist in Eastpointe, MI, you should know that financial relief may be available, especially if you have Medicare federal health insurance.
Here’s all you need to know about Medicare coverage and what dental procedures it covers.
Firstly, do all dentists accept Medicare?
The short answer is no. While Medicare is a nationwide scheme, not all dentists will accept payments made through the federal health insurance program.
Whether looking for a dentist near me that accepts Medicare or Medicaid insurance coverage, Patient Empowered Dentistry can support patients throughout Eastpointe, MI and the surrounding areas with their treatments and, where applicable, health insurance admin. Contact our office to find out more.
Why aren’t all dental procedures covered by Medicare?
First and foremost, it should be noted that Medicare is a federal health insurance scheme. Therefore, it should be no surprise that the insurance coverage cannot be used to pay for cosmetic treatments. So, if you are hoping to simply improve your smile through teeth whitening or alignment, you will be required to cover the full costs.
While Medicare is offered to over 70 million U.S. citizens, the service is designed to support individuals that meet certain criteria, such as;
- Senior citizens aged 65 or over,
- Disabled individuals,
- Low-income families,
- Pregnant women,
Naturally, then, all healthcare coverage (not just dental) offered under the Medicare scheme is built with eligible candidates in mind. Dental procedures that fall outside of the treatments commonly used by these demographics will not be included, which is vital to know before seeking a Medicare dentist near me.
So, what dental procedures does Medicare cover?
While Medicare coverage is a widespread health insurance scheme, not all members enjoy the same benefits. This is because Medicare is split into several parts;
- Part A – inpatient hospital coverage
- Part B – outpatient medical coverage
- Part C – extended medical coverage, which includes some dental services
- Part D – prescription drug coverage.
Therefore, when looking for a dentist near me with Medicare coverage and the treatments that may be included, you must consider whether you are protected by an Original Medicare or Medicare Advantage plan.
Dental support for Original Medicare plans
Holders of an Original Medicare plan should know that, generally speaking, they will get very limited support with dental work. In addition to prohibiting cosmetic procedures, it excludes standard cleanings, fillings, dental plates, dentures, extractions, and supplies.
Parts A of the plan means that you are covered for dental procedures completed while staying at the hospital. It can also cover emergency dentistry procedures, which includes works completed at a Medicare registered dentist office like Patient Empowered Dentistry.
Generally speaking, though, unless it is a medical emergency, you will be required to cover the full cost of any dental procedures completed at a dental practice.
Dental support for Medicare Advantage plans
Given the importance of a healthy mouth to your general physical wellbeing, it is perhaps a little odd that dental procedures are not covered by Original Medicare plans. On a brighter note, though, Medicare Advantage offers additional care that does extend to dental care.
Not all Advantage plans offer the same care, and the health insurance provider you partner with can have a telling influence on the possibilities. Nonetheless, Medicare Advantage can cover the costs (or at least some of the expenses) related to the following;
- Dental x-rays,
- Dental crowns and bridges,
- Dental cleanings,
- Root canal therapy,
- Oral examinations,
- And more.
There are limitations to how often treatments can be completed. For example, you may only be eligible for dental cleanings once every six months. However, mist candidates are permitted to enjoy several treatments on their Medicare Advantage plan.
It should also be noted that you may still be required to make a parietal payment yourself. Examples of this include a 50% coinsurance or a $50 copayment. Therefore, it’s best to speak with a local Medicare dental practice provider to discover where you stand.
The nature of the Medicare scheme means that dental coverage isn’t a priority, which is why only a limited number of dental procedures are covered – even when you are a Medicare Advantage holder.
Nonetheless, if you need dental treatments for health benefits (rather than cosmetic purposes) searching for a Medicare dentist near me can open the door to financial support. For help in Eastpointe and beyond, contact Patient Empowered Dentistry today!