In the U.S. when Americans turn 65 they are eligible for medical services and health insurance under the program called Medicare. Unfortunately Medicare doesn’t cover most dental care such as procedures and supplies like tooth extractions, cleanings, fillings, dentures, dental plates, or other dental devices.
Recent surveys have shown that most people are in favor of expanding Medicare to include services like dental an vision. Many are also in favor of lowering the age of eligibity to less than 65. As of 2023.
As of January 1, 2023, Medicare has now been expande to cover medically necessary conditions requiring dental services. According to the ADA the following dental services are now covered under Medicare:
- Extraction of teeth when it is to prepare the jaw for radiation treatment of neoplastic disease.
- Reconstruction of a ridge when performed as a result of and when at the time of the surgical removal of a tumor.
- Stabilization or immobilization of teeth when being performed to reduce a jaw fracture.
- Dental splints when used with a medically necessary treatment.
- Dental services when occuring prior to cardiac valve replacement, valvuloplasty or organ transplant procedures.
Such care can be performed in both an inpatient and an outpatient setting. Further, coverage applies to X-rays, anesthesia, or the use of an operating room for procedures that are deemed eligible under the rule.
It is noted that the ADA said that the Centers for Medicare & Medicaid Services will conduct an annual review to assess whether to include additional dental services that are deemed medical necessary. For those without the rescources to pay for dental services when they are eligible for medicare this may be welcome news. However, the scope of the dental services covered tha are deeme medicaly necessary are very limited. Perhaps in the future Medicare will continue to expand to include more and more dental services. It is possible that even one day Medicare will include all dental services. Unfortunately those on Medicare will have to continue to wait another calendar year for such a possibility.
Source: Jennifer Garvin, CMS expands Medicare to cover medically necessary conditions requiring dental services, ADA, November 8, 2022. https://www.ada.org/publications/ada-news/2022/november/cms-expands-medicare-to-cover-medically-necessary-conditions-requiring-dental-services