Medicare Dental Coverage: Are Any Dental Services Covered by Medicare?
Essentially, no dental procedures are covered by Medicare unless the dental issue is associated with another condition that resulted in hospitalization and was eligible for Medicare coverage.
Coverage is not determined by either the urgency of the condition or the seriousness of the illness or injury. What is critical here is the kind of service that is needed, the location and the time of the service, and the actual physical structure that is involved. If the procedure is to be covered by Medicare, it must be secondary and necessary to the primary service that is covered and is not a dental procedure. The service must be rendered while the primary service is performed, and it must be done by the same medical or dental professional. While the procedure may be covered, if the service is performed and the patient is in need of dental appliances, such as dentures, these are not part of Medicare coverage, even if the covered procedure produced the need.
Covered dental expenses would include the following: Extraction of teeth or jaw preparation with the intent of irradiating a growth or tumor; Dental examinations, without any dental treatment, before surgical transplantation of a heart valve or kidney.
For coverage, these kinds of procedures are required to be in-patient treatments, be an integral part of the treatment for the primary condition, and the must be done all at once.
Dental procedures or costs that are not included in the coverage are: Dental care involving the teeth or any supporting structures that comprise the primary procedure; Tooth replacement or extraction as a primary procedure; Dental work in preparation for dentures; Tooth extractions due to jaw infections; Dental work to repair supporting structures, which would include roots and root coverings, tooth sockets (alveolar bones), or any part or portion of the gums.
Any Medicare or Medicare associated program will give dental care some consideration. When calculating the out of pocket expenses that a patient is responsible for, the Centers for Medicare & Medicaid Service will look at the dental costs that are privately paid.
Dental procedures may be covered by an MSA (Medicare Medical Savings Account) that can be established by the patient. People do not deposit money into an MSA. The required funds will be paid only from the patient's Medicare account. MSA's have very strict requirements and have an associated deductible that the patient must satisfy with expenses that are qualified by Medicare before they can access funds from the account. The bank account that is created and holds the funds is selected by Medicare, and a debit card is usually used to make payments from the MSA. Some MSA expenses are taxable; however, dental costs are not taxed.
Another plan that may offer dental care along with additional long-term care coverage, are Social Managed Care Plans that are administered by Medicare and can be qualified for by certain individuals in a very limited number of cities.
Coverage is not determined by either the urgency of the condition or the seriousness of the illness or injury. What is critical here is the kind of service that is needed, the location and the time of the service, and the actual physical structure that is involved. If the procedure is to be covered by Medicare, it must be secondary and necessary to the primary service that is covered and is not a dental procedure. The service must be rendered while the primary service is performed, and it must be done by the same medical or dental professional. While the procedure may be covered, if the service is performed and the patient is in need of dental appliances, such as dentures, these are not part of Medicare coverage, even if the covered procedure produced the need.
Covered dental expenses would include the following: Extraction of teeth or jaw preparation with the intent of irradiating a growth or tumor; Dental examinations, without any dental treatment, before surgical transplantation of a heart valve or kidney.
For coverage, these kinds of procedures are required to be in-patient treatments, be an integral part of the treatment for the primary condition, and the must be done all at once.
Dental procedures or costs that are not included in the coverage are: Dental care involving the teeth or any supporting structures that comprise the primary procedure; Tooth replacement or extraction as a primary procedure; Dental work in preparation for dentures; Tooth extractions due to jaw infections; Dental work to repair supporting structures, which would include roots and root coverings, tooth sockets (alveolar bones), or any part or portion of the gums.
Any Medicare or Medicare associated program will give dental care some consideration. When calculating the out of pocket expenses that a patient is responsible for, the Centers for Medicare & Medicaid Service will look at the dental costs that are privately paid.
Dental procedures may be covered by an MSA (Medicare Medical Savings Account) that can be established by the patient. People do not deposit money into an MSA. The required funds will be paid only from the patient's Medicare account. MSA's have very strict requirements and have an associated deductible that the patient must satisfy with expenses that are qualified by Medicare before they can access funds from the account. The bank account that is created and holds the funds is selected by Medicare, and a debit card is usually used to make payments from the MSA. Some MSA expenses are taxable; however, dental costs are not taxed.
Another plan that may offer dental care along with additional long-term care coverage, are Social Managed Care Plans that are administered by Medicare and can be qualified for by certain individuals in a very limited number of cities.
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