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Q: Does Health Insurance Cover Dental Care?

Hal Levy September 19, 2017

Health Insurance

Individual plans may offer dental care, but your plan isn’t required to include it. Dental coverage is frequently added to employer-based group plans, although they don’t have to provide dental care either.

Since dentistry isn’t considered an essential health benefit, there’s a great deal of variation between what each plan offers. You’ll have to check with your plan to see how it covers dentist checkups, tooth decay, and gum disease. Dentures and orthodontic work may or may not be treated the same as other basic dental needs.

There are plenty of surprisingly affordable dental-only insurance policies that are separate from your main health insurance. These will work like traditional health insurance, but will only cover dental work. You can compare standalone dental policies with HealthCare.com’s search engine.

Childrens’ Care

Your health plan must offer dental care to children 18 or under. Although you don’t have to purchase child dental coverage, it must at least be available as a benefit.

If you do include dental care with your health plan, then your premium and deductible will apply to dental care.

Medicare, Medicare Supplement, and Medicare Advantage

In general, Original Medicare (Parts A and B) does not cover the cost of dentures, routine dental exams, or tooth fillings. There are no Medicare Supplement plans that add dental coverage either.

Some Medicare Advantage plans (Medicare Part C) come with dental insurance. You can see if any Medicare Advantage plans in your area cover hearing aids and exams by using our Medicare Advantage plan comparison tool.

Medicaid

Medicaid coverage varies by state. Some state Medicaid programs offer full oral health benefits, including coverage for root canals and crowns. As of 2016, seventeen states offer nothing more than emergency coverage, or no coverage at all. The Kaiser Family Foundation lists state-specific information regarding Medicaid coverage for dental care.

Veterans’ Benefits

Recently discharged veterans may be eligible for routine dental care if they apply within 180 days of their discharge. If you have a service-related dental issue or a 100% disability rating, you can get dental care. If your dental health interferes with a surgery or certain vocational programs, you may also be able to receive dental care through the VA.

Flexible Savings Accounts (FSA) + Health Savings Accounts (HSA)

Virtually all medically appropriate dental care qualifies as an eligible FSA or HSA expense. Unlike FSAs, money in your HSA accumulates from year to year, allowing you to save toward the cost.

Taking the Next Steps

You can evaluate your health coverage and see if it’s the best option for your needs – and find standalone dental plans to supplement your current coverage. Search our database of individual health insurance plans to find the right plan for you.

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