As the Social Security Act currently stands there are very few dental services covered by Medicare. As part of the original Medicare program, the Social Security Act called for a blanket exclusion of dental services. While this exclusion was amended in 1980 to include dental procedures that made inpatient hospitalization necessary, primary dental care services (i.e. care and treatment) and secondary dental care services (i.e. repairing teeth or teeth structures) are not covered by Medicare. Medicare provides little to no dental coverage, but dental plans Medicare may be available to some individuals and their families.
If the dental treatment and care happens to be part of a procedure already covered by Medicare, Medicare will pay for the dental service. In other words, when dental services are required to protect the overall health of an individual Medicare will pay for these necessary dental services. Examples include: oral examination for gum disease prior to kidney transplant or heart valve replacement; dental services necessary to undergo radiation treatment for illnesses such as cancer; jaw reconstruction due to removal of facial tumor or due to facial fractures; dental splints and wiring due to jaw surgery. Medicare will not pay for any follow-up dental care treatment or procedures. Dental plans Medicare only cover serious health problems that require dental care or services prior to treatment.
Medicare supplement plan members can purchase PPO (Preferred Provider Organization) dental coverage. This plan offers individual and two-party coverage, and covers services such as exams, cleanings, x-rays, anesthesia, restorative dentistry, crowns, oral surgery, veneers, and periodontics. These plans cover a percentage of services provided by both in-network and out-of-network dentists. PPO dental plans also have per member deductibles and calendar-year benefit maximums. Dental plans Medicare may be purchased by Medicare recipients for additional an fee and the dental services offered by this type of coverage may vary.