Affording dental work can be tough if you’re an older American on Medicare.
That’s because Original Medicare — which covers a majority of beneficiaries — doesn’t include routine dental care.
The Centers for Medicare & Medicaid Services announced plans to begin covering limited dental services starting January 2023. But the scope is narrow: Dental work must be linked to a covered medical procedure, such as before an organ transplant, to qualify for coverage.
For now, older adults are mostly on the hook when it comes to paying for their own oral health care.
Here are seven ways to get free or reduced dental care. We’ll also explain what limited dental benefits Medicare coverage provides, along with other options like private insurers and Medicaid.
7 Places To Get Cheap or Free Dental Care for Seniors
Medicare beneficiaries who use dental services spent an average of $874 a year out-of-pocket, according to an analysis by the Kaiser Family Foundation.
That’s a lot of money, especially if you’re on a fixed income.
Here are a few tips and tricks to get free dental work and save big on oral health.
1. The Dental Lifeline Network
This program by the American Dental Association offers free, comprehensive dental treatment to specific groups, including people ages 65 and older.
You can use this tool on the Dental Lifeline Network website to learn about the specific program details in your state.
Heads up: Due to long wait lists, several states and counties are no longer accepting new applications for the Dental Lifeline Network program. When we did a quick search, Nevada and Wisconsin weren’t accepting new applications.
2. Community Health Clinics
Federally funded community health clinics provide reduced-cost or free dental care services to people with low incomes.
Many operate on a sliding scale system while others offer flexible payment plans.
Wait lists can be long, so it’s important to reach out to your local clinic early.
Follow this link to find the nearest community health clinic near you.
3. Dental Schools
Some dental schools offer low-cost cleanings and other routine care to members of the community.
Most of these teaching facilities have clinics that give dentists-in-training an opportunity to practice their skills while providing low-cost dental care to the public.
You can search for dental schools and programs in your area by visiting the American Dental Association website.
There’s no guarantee that a dental program in your area currently offers free or reduced dental care. You’ll need to contact each program individually to see what’s available.
When you call, make sure to ask about any fees up front.
4. NeedyMeds.com
This website offers a comprehensive list of dental offices with sliding scale payment options, community health center locations and dental school clinics.
It does a great job breaking down requirements and eligibility (if any) for services in your area, and provides contact information for each service.
Just enter your zip code into this search tool to get started.
5. Talk With Your Dentist
It might be difficult to ask for help, but being honest with your dentist about your financial situation can help.
Your dentist may be able to offer a less expensive treatment, help you set up a payment plan or provide a sliding scale payment option.
Ask if you can receive a discount for referring a friend. Or, see if it’s possible to knock off a few bucks in exchange for a positive online review of the dentist office.
6. Sign Up for a Dental Savings Plan
Dental savings plans aren’t dental insurance, but they may still be able to save you money.
Here’s how it works.
With a dental savings plan, you pay an annual fee, then get a 10% to 60% discount on most dental services such as exams, cleanings, fillings, root canals and crowns.
The plan contracts with dentists who agree to reduce their fees, then you pay the participating dentist directly using your discount.
You’ll still pay out of pocket for those services, but the idea is that you won’t pay as much as you would without the plan.
But let’s be clear: Dental discount plans aren’t free. The average cost for plans in Orlando, Florida, for example, ranged between $135 to $170 a year.
You can visit DentalPlans to find a plan in your area.
7. Shop Around
Dentists can charge widely different prices for the same exact procedure.
When it’s coming out of your pocket, it pays to shop around.
You can find average prices in your area by using FAIR Health, a national nonprofit organization. The site lets you search by specific procedures, so you get the average cost for a root canal or teeth cleanings in your area.
Armed with knowledge, call around to different dentist offices for quotes. Ask about senior discounts.
You can also look for discounted dental care on sites like Groupon.
A quick search on Groupon for dental services in Houston, Texas, showed numerous X-ray, exam and cleaning packages for $25 to $50. One office even offered $700 toward dental implants for just $50!
If you reside in a high cost-of-living area, driving to a less expensive area is another smart way to find low-cost dental care.
Does Medicare Cover Dental Care?
Yes and no.
Original Medicare doesn’t provide coverage for routine dental, vision or hearing benefits.
Original Medicare will only cover dental work if it’s deemed medically necessary, i.e. you were hospitalized after a traumatic injury that also affected your jaw, teeth or mouth.
Starting Jan. 1, Medicare will begin covering the following dental procedures:
- Reconstruction of a ridge when performed at the same time as the surgical removal of a tumor.
- Stabilization or immobilization of teeth when done in connection with the reduction of a jaw fracture.
- Dental splints when used in conjunction with a medically necessary treatment.
Here are the other dental services covered by Medicare Part B:
- Dental services that are critical to a larger procedure like facial reconstruction after an accident.
- Tooth extraction that is needed to prepare for radiation treatment.
- Oral exams and treatments that are done to prepare for a kidney transplant, heart valve replacement or organ transplant procedures.
So if you’re looking for standard dental care like teeth cleaning, X-rays, fillings, extractions, dentures and more — the cost comes out of your pocket.
Medicare Advantage
Medicare Advantage plans are administered by private insurance companies. They must provide the same basic coverage as Original Medicare, but plans may offer additional benefits, such as dental.
About 94% of private Medicare Advantage plans provide some dental coverage, but the amount of coverage varies by plan.
Nearly all Medicare Advantage plans that include dental offer coverage for oral exams, cleanings and X-rays, according to the Kaiser Family Foundation.
But benefits for more advanced dental work like root canals, implants and dentures can carry substantial copays, depending on the plan.
Medicare Advantage plans almost always impose restrictions, including annual dollar caps and how often you can get certain benefits, such as dental implants.
The average annual limit on dental benefits among Medicare Advantage plans that offer more extensive benefits was about $1,300 in 2021, according to KFF.
If you’re enrolled in a Medicare Advantage plan, it’s important to check the plan’s summary of benefits or evidence of coverage to see exactly what dental work is covered. It can vary widely from plan to plan.
Other Dental Insurance for Seniors
About half of all Medicare beneficiaries — 47% — did not have any form of dental coverage in 2019, according to the Kaiser Family Foundation.
Besides Medicare Advantage plans, other sources of dental coverage for seniors include Medicaid and private plans, such as employer-sponsored retiree plans and individually purchased dental plans.
Private Dental Insurance for Seniors
A standalone dental policy for people 65 and older is typically $20 to $50 a month, according to AARP. You can expect an annual deductible of $50 to $100 with these policies.
Dental insurance plans usually cover checkups and cleanings 100% but you will probably owe 20% to 50% for other services, such as tooth extractions or dentures.
The devil is in the details with private dental plans: It’s important to shop around and carefully compare benefits to make sure you’re getting the best deal.
Here are a few other things to keep in mind about private dental insurance plans:
- You can’t enroll in a dental plan through the federal ACA Marketplace if you’re already enrolled in Medicare.
- Private dental policies usually don’t charge higher monthly premiums if you’re over 65 or in poor health.
- An insurance company may require you to undergo a waiting period before you can get expensive procedures.
- Some plans won’t cover pre-existing dental conditions you had before enrolling in coverage.
- You may be restricted to an in-network dentist, so check to see if your dentist is on the list.
Medicaid
About one in five Medicare beneficiaries is also enrolled in Medicaid, sometimes referred to as being “dual enrolled.”
Medicare usually pays as your primary insurance when you’re dual enrolled. But if you need dental work done or even a yearly cleaning, consulting your Medicaid handbook is a smart move.
If you meet Medicaid low-income requirements in your state, you may be able to receive free or low-cost dental care for certain procedures and services.
But it’s not a guarantee. While most states provide at least some emergency dental services, only 39 states and Washington, D.C. offer limited or comprehensive dental benefits for adults, according to the National Academy of State Health Policy.
Even if your state Medicaid program includes dental, it may not pay out much. Of the 39 states with routine dental care coverage, only 25 states offer an annual expenditure cap of $1,000 or more.
Adult Medicaid recipients in Arkansas, for example, only receive annually up to $500 of dental services, and that excludes dentures and tooth extractions. So if you need a $3,000 root canal and you’re dual enrolled with Original Medicare, you can expect to pay $2,500 out of pocket in that state.
According to Medicaid’s national website, “States have flexibility to determine what dental benefits are provided…There are no minimum requirements for adult dental coverage.”
To find the Medicaid office contact information for your state, click here.
Rachel Christian is a Certified Educator in Personal Finance and a senior writer for The Pointypress.
