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Does Medicare Cover Oral Surgery?

Dental health isn’t confined solely to the realms of cleaning, dentures, and braces. A dental check-up can also help diagnose underlying severe medical issues that may require oral surgery. 

Should you require a more serious need for oral surgery such as tooth extraction, jaw reconstruction, facial fractures, and dental implants, your dentist will likely refer you to a specialist.

When the time comes that you require oral surgery, you will undoubtedly question whether your Medicare plan will cover the cost. There are different coverage rules for oral surgery so it’s important to understand your plan so that you can determine what your out-of-pocket costs will be. Here is a guide of what you can expect your Medicare plan to cover:

Medicare and Routine Dental Coverage

Routine dental care such as cleaning, fillings, braces, and dentures is outside of what Medicare will help pay towards. For insurance that covers such procedures, patients must acquire coverage beyond Medicare Part A or Part B

That is except for specific circumstances. If you had to have a dental procedure in order to treat another medical condition, it is possible that it may be covered by Medicare. 

Does Medicare Cover Oral Surgery?

Although Medicare Part A and Part B do not cover routine dental services, oral surgery may be covered by Medicare if it is determined to be medically necessary. So, if your health is at risk without it or if the oral surgery is part of a broader treatment plan that Medicare covers, it is possible that Medicare will cover it. 

Examples of this include removing tumors in the mouth or face and reconstructing the impacted area, repairing the jaw following a fracture, and extracting damaged teeth before radiation treatment or organ transplant.

Every circumstance is different. So the best way to know whether your oral surgery is covered by Medicare is to ask the dentist that ordered the surgery. 

If applicable, Medicare Part A would cover some of the hospital and surgery costs and Part B would cover oral surgery or tests performed in an outpatient setting. Part D would cover any medications prescribed to the patient before or after an oral surgery procedure.

Medicare Advantage plans provide the oral surgery benefits as Medicare Part A and Part B, but some may also provide coverage for routine dental services such as dental exams, fillings, dentures and more.

Finding the Right Dental Coverage for You

As we age, the risk of dental problems is increased. It’s important to remember that Medicare will not cover oral surgery if it is solely intended to treat your teeth. In this case, you will likely pay the full cost of your oral surgery unless you have a Medicare Advantage plan that offers dental benefits.

To learn more about your Medicare Advantage plan options and to find a plan covers your oral surgery and dental care needs, speak with an insurance agent at 1-844-236-0228 or request a free quote