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You are here: Home / What Medicare Covers / Medicare Breakdown: Is Oral Surgery Covered?

Medicare Breakdown: Is Oral Surgery Covered?

November 13, 2020 by senioraffairs

does medicare cover oral surgery

Medicare can be difficult to navigate at the best of times. So click this link to learn whether or not your oral surgery procedures will be covered by Medicare.

The risk of getting cavities, gum disease, and mouth cancer increase with age, warns the American Dental Association. More than 500 medications may cause dry mouth, which can lead to cavities and tooth decay. The same source reports that most individuals diagnosed with mouth cancer are around age 62.

Oral surgery is often the only way to deal with some of the dental problems listed above. Depending on your condition, you may need dental surgery to remove an impacted tooth, get a dental implant, or restore your bite.

Other common problems, like sleep apnea or jaw misalignment, may require maxillofacial surgery. Seniors with oral cancer may need one or more procedures to get their tumors removed. As you would expect, these treatments can run into five figures.

The good news is, Medicare covers oral surgery in certain conditions. How much you’ll pay out of pocket depends on your health insurance plan. Read on to find out more!

Table of Contents hide
1 Does Medicare Cover Oral Surgery?
2 Medicare Advantage and Dental Surgery
3 Healthy Teeth, Healthy Life

Does Medicare Cover Oral Surgery?

Medicare coverage can be confusing for those who are insured. There’s Medicare Part A and Part B, Medicare Advantage, Medigap, and more. So which of these plans cover oral surgery?

Original Medicare, which includes Part A and B, doesn’t cover the cost of dental services. However, these plans do provide coverage for oral surgery if it’s medically necessary.

For example, if you have an accident that results in jaw fractures, then dental surgery may be your only option.

In this case, Medicare Part A will cover some of the costs of the procedure and hospitalization. Part B, on the other hand, will pay the cost of dental surgery performed on an outpatient basis.

Oral surgery may be medically necessary if you have a damaged tooth. It may also be the only option for treating dental infections, oral cancer, or jaw fractures.

If, say, you have neck cancer, Original Medicare may cover the cost of tooth extraction prior to radiation. The downside is that it won’t pay for preventive care services designed to reduce your risk of radiation cavities. In this case, it’s worth enrolling in a Medicare Advantage plan.

Medicare Advantage and Dental Surgery

Original Medicare will only cover dental exams, tooth extractions, and other dental services if they are necessary for a medical procedure, such as oral surgery. But you can always opt for Medicare Advantage. Some plans provide dental coverage, while others allow you to add it to your policy.

Medicare Part D, for example, will pay for any prescription drugs required during and after oral surgery. Part C may cover oral surgery, depending on your insurance policy.

Some Medicare Advantage plans don’t cover dental services at all. That’s why you should discuss your options with a licensed advisor before signing up. He can help you understand what’s covered under each plan, how much you must pay out of pocket, and which services are excluded.

Healthy Teeth, Healthy Life

Oral surgery can be expensive and requires follow-up care. Choosing a Medicare plan that includes dental coverage is one of the best things you can do for your health. Take the time to research your options on our site to help you make an informed decision.

Interested to know more about dentures, fillings, and other dental services? You’re in the right place. See our guide to Medicare dental coverage before choosing a plan.

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