Q:

What dental procedures are covered by Medicare?

A:

Quick Answer

Some dental procedures covered by Medicare, as of 2015, include surgical reconstruction of the jaw due to an accidental injury and dental extractions prior to radiation treatment. Medicare provides limited dental insurance and only covers services that are considered to be medically imperative, states Consumer Guide to Dentistry.

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Full Answer

Medicare, which is divided into Part A and Part B, is a health insurance program administered by the Centers for Medicare and Medicaid Services (CMS). Eligible recipients of dental benefits include people age 65 and older, disabled patients and those with long-term renal disease. By virtue of the statutory dental exclusion of the Social Security Act, coverage is not provided for the majority of routine dental work, including dental care, treatment, teeth and dental structure replacement, extraction and filling, notes CMS.

An exception to the statutory dental exclusion clause is when a Medicare beneficiary requires dental services in an inpatient facility due to an underlying medical condition. For instance, dental treatment for infections developed following an extraction is covered under Part A of the Medicare program. Members who undergo complicated dental procedures in a hospital or those who require further observation after a dental operation due to their health status are also covered.

Other exceptions to excluded dental services include preparatory dental extractions for radiation therapy to treat neoplastic disease. Prior inpatient dental checkups as part of a thorough diagnostic examination of a beneficiary undergoing kidney transplantation or heart valve replacement are also covered under the Medicare program.

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