Why Doesn’t Medicare Pay For Dental Care?





Some dental care covered

For those who may have heard such a thing mentioned, this statement needs to be modified. For one thing, if dental services are required to protect your general health, then Medicare will indeed cover them. This applies, for instance, if a patient requires surgery to treat a facial or mandibular fracture; one cannot, however, receive coverage beyond what is required for the underlying health condition. In addition, some private Medicare plans do cover routine dental services.

Why dentistry is not covered

But the fact is that dental care — like hearing aids and eyeglasses — is excluded by the statutes that created both Social Security and Medicare from coverage in those programs: Changing that would require an act of Congress. The reason for such exclusion is because dentistry is not considered a branch of medicine; dental work is not performed by physicians in hospitals. Dentistry did not even develop as a separate profession until the nineteenth century, and has always required a separate training program, degree (D.D.S. or D.M.D.) and license, from the work done by doctors with an M.D. For much of its history, dental work was relatively inexpensive; it consisting of nothing more than repairs and removal of teeth and the construction of dentures. The need for dental insurance was seen as less urgent than the need for medical insurance, because teeth decay slowly, and medicine — such as aspirin or acetaminophen — exists which can ease the pain. So the need for insurance to cover treatment of caries was not seen as urgent enough to justify Medicare coverage.

One last word

Medicaid does cover dentistry.



16 Responses to “Why Doesn’t Medicare Pay For Dental Care?”

  1. Jake Wong says:

    Dear Sir and/or Madam:

    Your website is informative. With respect to your explanation regarding why dental care is not covered by Medicare, I would like to direct you to the following article published in 1980 by Dr. H. BARRY WALDMAN, DDS, PHD, MPH, entitled “The Reaction of the Dental Profession to Changes in the 1970s.” In the article, Dr. Waldman notes:

    “In the mid-1960s, during the Congressional review
    of the then pending Medicare and Medicaid legislation, the
    ADA opposed dental care for the aged under the Medicare
    bill, while lobbying for the inclusion of dentistry as a benefit
    under the proposed extension to the Kerr-Mills legislation
    for services to the poor (Medicaid).”

    As it turns out, the American Dental Association (ADA) opposed (and continues to oppose) dental care for the aged under the Medicare bill.

    I can forward you a copy of this article if you would like.

    Thank You.

    Sincerely,

    Jake Wong

  2. Edna says:

    Medicare should be forced to cover dental care for women with serve osteoporosis. I have that, and my teeth have been fracturing below the gumline. I now have five broken lower teeth, and am being denied care. A low income dental clinic will not cover me, they are afraid of fracturing my jaw. I have an infection that can kill me. As soon as I am through these antibiotics, I have to start all over again, trying to find help. Women with severe osteoporosis are as high risk as people with dialysis, chemo or radiation. Our immunity system is weakened, we can die of infections of our blood, heart or brain, but no one cares or wants to help.

  3. earl leavitt says:

    yes i have a very good question why does medicaide pay for dental and eye exams and glasses and people are given medicaide at no cost to them but i have to pay over a hundred dollars a month for medicaire whether i use it or not and eyes and dental work are not covered seems to me something is definitely wrong they have it totally backwards what is wrong with the system and beleive me i am not the only one asking this question.

  4. Hazeleyez says:

    Because obama has everything fucked up and does not care about low or middle class people and everyone will see and realize hr is the antichrist and to think I voted for his sorry ass?

  5. The Medicare program does not cover routine dental care, hearing aids or eyeglasses for they are statutorily excluded from coverage.

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  7. Calahan says:

    Studying this write-up – the present of your time

  8. Ivey Wicketts says:

    Hand surgery is so much FUN! You’ll be amazed at how much you use that finger. I promise you. Hope it takes a while for you to get to the point of needing the surgery, and that you heal up real fast when you do.

  9. Anil Mitra says:

    I hope congress will consider adding dental and vision care to medicare. Most dental insurance plans are not very good and many limit the amount they will pay a year. If medicare included dental care it might force dental insurance carriers to provide better coverage. I would also like to comment on some comments made on Obama–medicare was setup long before his time and his administration not reduced medicare coverage.

  10. Scott says:

    Well medicaid in Illinois will not pay for dental work anymore for anyone over 20, I have a broken tooth and need help, try getting it here in Southern, IL. I am disabled and on S.S. with medicare and a supplemental medicaid card, neither one does a damn thing for me, when I need dental help, so I have to sit around in pain and use pliers and slowly dig out teeth myself because only the rich get what the need in this hellish nation, perpetuated by the assholes in the local, state and national government positions, who never had it rough a damn day in their lives. Dental costs are almost as expensive as medical, so forget going to see a dentist, unless you’re Bill Gates! All of my monthly check goes to keep me in a home and food, I barely have $100 left after that to just get by for the rest of the month and I still have to get the drugs I need to live with that.

  11. nancy says:

    i had a sister that had a tooth get infected and could not get help with her dental. the tooth abcessed she spent 4 weeks in ICU in Utah and the cost to medicare was astronomical…it could have all been avoided if she could just have had the tooth fixed..Seniors need dental coverage just as much as they need medical coverage. speak up seniors…tell the government over and over and over until we get help for dental…

  12. Michele says:

    I have also ended up in the hospital with a dangerous infection from a tooth I couldn’t afford to have pulled. I have existing medical conditions and a regular dentist won’t pull them. The oral surgeon wants 195.00 for x- rays and 225.00 to 275.00 to pull the tooth. I have. 56.00 left over from my ss check after paying the rent and electric budget payment. I struggle to afford food and can no longer afford heat. It’s been 3 years since I have been able to buy 100 gallons of oil at over 300.00 but yet my family dr. Thinks I should be able to go to an oral surgeon or I will die he says. After my last hospitalization , I was scared I would die and did take the money to pay the surgeon instead of paying my rent. I couldn’t make up the rent payment and then ended up homeless for 3 months .i finally found someone who would rent to me and didn’t charge the first months, last months, and security deposit so I could have a roof over my head again. The home is a shack, but its way better than being homeless. Now I have another infected tooth and it may come down go being homeless again. I have done many rounds of antibiotics and my gp won’t give me anymore because I need to,see an oral surgeon. Advil will no longer help,the pain nd I haven’t slept much in days. I am not a young woman and being homeless in poor health is so hard. Last time Medicare had a huge bill for my hospitalization from massive infection from the tooth but wouldn’t pay 450.00 for a tooth extraction to save my life. We spend so much on foreign aid, but people,die,here and go homeless from dental infections. We need dental coverage. It is health care as well and you can die if you can’t get treatment. I’m so afraid of having to make the choice to leave this home and become homeless again and get the tooth done before I die . Winter is coming and I nearly froze to death the last time I was without a home. Please fight for dental coverage .

  13. Fran says:

    I have paid out $1300 for scaling & planing because of gum disease….I have to have a lot more work done or my ‘regular’ dentist will not be able to work on me for even teeth cleaning. Supposedly if you don’t get periodontal care, you end up with heart disease – just like with your pets. It doesn’t make sense there is NO HELP available for Seniors. If I get ALL my teeth pulled and can’t eat, will that make a difference? Just want to know what the catch 22 is here.

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