Does Medicare cover dental care in Texas?

It's one of the most common questions we hear from patients turning 65. The short answer: Original Medicare usually doesn't cover routine dental care, but many people in San Antonio have dental benefits through a Medicare Advantage plan without realizing it.

What Original Medicare covers

Original Medicare (Parts A and B) generally does not pay for everyday dental care like checkups, cleanings, fillings, extractions or dentures. There are narrow exceptions, such as certain dental care needed before or during some medical treatments in a hospital, but for most people, routine dental care isn't included.

Where seniors get dental coverage

• Medicare Advantage (Part C) plans. Many include dental benefits. Common ones in San Antonio include plans from Humana, AARP and UnitedHealthcare, Aetna and Blue Cross Blue Shield of Texas.
• Separate dental plans. Some people buy an individual dental plan, for example from Mutual of Omaha or Ameritas.
• Retiree plans. Former federal employees and military retirees may have dental through GEHA or other FEDVIP plans.

Five things to check on your plan

1. Is it a PPO or an HMO? Dental PPO plans let you choose your dentist. Some HMO medical plans still pay dental as a PPO, so it's worth asking.
2. The yearly maximum. Many Medicare dental benefits cap what they pay each year.
3. What's covered. Some plans cover only cleanings and exams. Others help with fillings, crowns or dentures.
4. Waiting periods. Some plans make you wait before covering larger treatment.
5. When it resets. Most benefits renew each January and don't roll over, so unused benefits are lost.

Use your benefits before they reset

If you haven't used your dental benefits this year, a checkup and cleaning is an easy place to start. It keeps small problems small, and it lets us show you exactly what your plan covers before any treatment.