Dental insurance for seniors: Medicare, Medicare Advantage and other routes

In most cases, no. Medicare.gov says Medicare does not cover routine dental services such as cleanings, fillings and tooth removals, or items such as dentures and implants. It may cover certain hospital inpatient dental services and dental care linked to specific covered treatments. Some Medicare Advantage plans add routine dental.

Some do. CMS says some Medicare Advantage plans may cover and pay for routine and other dental services as an added benefit, and Anthem says most of its Medicare Advantage plans include built-in routine dental and vision. What is included, the annual limit and the network vary by plan, so read your evidence of coverage.

Yes. Anthem says that with Original Medicare, a Medicare Supplement plan or a Part D plan, you may want an individual dental plan, and UnitedHealthcare lists Dental Gen plans designed for adults age 64 and older. Compare waiting periods, annual maximums and networks before you choose.

It depends on the plan and its annual limit. Dentures are major care on MetLife, Guardian, Cigna and Humana, and an annual limit can be used up by one treatment. Ask the plan what it pays toward dentures, whether a waiting period applies and how relines and replacements are treated.

Kaiser Permanente's Washington page describes an optional supplemental Delta Dental plan available for an extra monthly premium, on top of a preventive dental benefit built into its Medicare Advantage plan. Anthem describes tiers of optional dental and vision benefits with different annual limits. Ask what the extra premium adds.

It depends on the state. CMS says some states may cover routine and other dental services for people eligible for both Medicare and Medicaid. Check with your state Medicaid agency. The National Institute of Dental and Craniofacial Research says most states cover limited dental services for adults, and some cover more.

Some can. The VA places veterans in benefit classes based on service history, current health and living situation, and the class decides which dental benefits they may receive. Check the VA page or a VA office to find your class, and ask about insurance options if you do not qualify.

Look at reduced-cost care. Dental school clinics, hygiene school clinics and community health centers may offer lower fees, and a discount plan can lower prices at participating dentists. Do not delay urgent problems. See the guides to low-cost care and to dental care without insurance.

Yes. Medicare Advantage benefits and premiums can change from one plan year to the next, and individual dental plans renew annually. At each enrollment, check the covered services, the annual limit, the network and any waiting periods against the treatment you expect.

Some can be. Dry mouth, which certain medications cause, and gum disease are among the problems the National Institute of Dental and Craniofacial Research describes on its pages, and tooth loss is a reason many people need dentures later in life. Regular checkups and daily care help, and your dentist can tailor a plan to your health and medications.

Check what the plan pays for out-of-network care before you book. Kaiser Permanente's Washington page says you may choose any licensed dentist, but an out-of-network dentist's fees are outside the plan's control and you may pay the difference and file the claim. UnitedHealthcare says some plans pay nothing or less for out-of-network dentists.

Ask the office for a written, itemized estimate and a pretreatment estimate sent to your plan. If you have no coverage, you are usually entitled to a good faith estimate, according to CMS and the American Dental Association. Compare estimates from two offices using the same line items.