Medicare is part and parcel of aging. It’s an important means by which seniors can access important healthcare coverage when they need it. These services are vital for many seniors who need specialized care, medical treatments and medication, and are often supplemented by Medicaid, the federally-funded and state-administered program of low income care.
There are certain services, however, that may not be covered as completely as others. Dental care, for example, is very important to our overall health, but is it available under Medicare and Medicaid? Let’s examine dental insurance for seniors under Medicare and Medicaid, when services are covered and how the laws function overall.
Dental Insurance for Seniors under Medicare
The current laws allow for certain dental services to be covered under Medicare. These are only those services, however, that are part of another procedure that is covered or for those tooth extractions performed to prepare for treatment of neoplastic diseases of the jaw with radiation. If the procedure is covered by a dentist on staff at the hospital, the procedure is under Part A. If performed by a physician, it’s covered under part B.
There is a statutory exclusion which precludes coverage of the removal, replacement, filling, treatment or other care of teeth or support structures for teeth, unless the services are performed following hospitalization related to the services. This exclusion has been in place since 1980 and has never been revised.
In addition, under part B, primary services provided for tooth care are excluded, as are secondary services which are not absolutely necessary to treat non-dental conditions.
Dental Coverage under Medicaid
Under Medicaid, each individual state has the flexibility to decide what benefits can be provided to Medicaid recipients. In Ohio, seniors can be covered for the following services:
- Checkups and cleanings once per year with a $3 copay.
- Dentures based on the medical need for them, with authorization by the state. There’s a $3 copay.
- Fillings, extractions and crowns are covered with a $3 copay based on medical need if approved by the state.
- Root canals are available to all beneficiaries if needed, with a copay of $3.
Additional medical and surgical services are available based on medical needs.
The good news is that many retirees qualify for Medicaid, which is a need-based program into which many seniors on a fixed income fit. Medicaid in Ohio provides a fairly comprehensive package of medical services which can help address both immediate medical needs as well as preventative services.
Seeking Legal Help
Few people consider the idea of seeking legal help from an attorney in terms of getting medical coverage, but the truth is, estate planning and elder law attorneys can be a great resource for a number of issues, including how to qualify for dental insurance for seniors under Medicare or Medicaid.
At Stano Law, we’ve heard just about every kind of story in elder law over the years we’ve served the communities of Ohio, and we’ve helped a lot of people with their finances. If you need help with any form of elder law or estate planning services, or just want more information, give us a call to discuss your case today.