Does Medicare cover dental in South Dakota?

Does Medicare cover dental in South Dakota?

Last updated on: November 10, 2022

When signing up for Medicare, it can be hard to figure out exactly what coverage to expect from each aspect of coverage in South Dakota. When it comes to Medicare dental, the best dental insurance for seniors on Medicare will require a Medicare supplement plan to best meet their needs. Although not offered as a part of Original Medicare, getting a private Medicare Advantage Plan in SD that offers dental coverage will prove to be the best way to meet that need. While there is a narrow range of dental-related procedures covered by Original Medicare, after examining that range and its limitations, the necessity of a supplemental plan to get that full coverage should be clear.

Does Medicare cover dental in South Dakota?

In most cases, Medicare does not cover dental treatment in SD. However, some exceptions do exist: such as reconstructive surgery if the jaw or teeth were injured during another procedure, or in the case of extractions done for neoplastic diseases involving the jaw. Medicare will also help cover charges related to oral exams before procedures like kidney transplants or heart valve replacements under certain circumstances. This also allows Medicare to cover some of the costs relating to certain treatments for the periodontium, which includes the gingivae, periodontal membrane, and alveolar bone. However, to be clear these exceptions cover situations where the treatment is secondary to a larger medical issue related to the teeth themselves and exclude the vast majority of direct dental work or regular dentist visits in SD. These types of exceptions have been worked into the legislation of Medicare and the Social Security Act since 1980, and at the current rate appear to remain at about their current level of coverage. While original Medicare (that is, Medicare Parts A and B) generally do not include dental treatments as part of their coverage, many private Medicare Advantage plans (also called Medicare supplement plans or Medicare Part C) do offer some form of dental coverage as part of the different plans they offer. Since Medicare Advantage plans are privately offered, the individual costs and types of dental coverage available may vary from state market to state market or from company to company. However, for those seniors looking at options within the framework of Medicare that can help them with dental options, those plans will typically offer the kind of coverage needed.

How to sign up for Medicare dental plans in South Dakota

Medicare dental plans are typically an aspect of other Medicare Advantage plans, and thus have similar restrictions and guidelines for signing up. You have to be 65 or older and already signed up for Medicare Parts A (and usually B as well, depending on the plan,) and live in the area that particular plan covers. Depending on whether the plan is an HMO or PPO will slightly change how you go about finding coverage, your HMO’s primary care provider may refer you to a dentist, or a PPO may have a dentist in its list of preferred specialists (or you may find one outside of that group for an additional cost). From there, your dental coverage should be the same as any other kind of special coverage gained through a supplemental Medicare plan. These plans typically carry monthly premiums with them but will cover certain procedures, medical visits, or even prescriptions depending on the individual plan. Of course, more benefits offered typically lead to higher prices, but due to the competition between private Medicare Advantage companies, these will often be relatively similar depending on the benefits offered. Exact prices and coverage will depend then on where you’re looking and the precise companies you’re looking at.

At first glance looking purely at Medicare Parts A and B, there might seem to be only limited circumstances in which you’d be covered when it comes to Medicare dental coverage in SD, but with dental coverage from a Medicare Advantage plan, if you can get the right balance of coverage and cost, you should be able to find a service that greatly improves your quality of life like with any Medicare supplemental insurance. Like finding any sort of supplemental Medicare Advantage insurance, it’s simply a matter of finding which plans offer dental coverage in your area and comparing their prices and coverage. One of the best ways to make those sorts of comparisons is with EnrollMedicare, where we can help compare different local competitors to help find the best dental insurance for seniors on Medicare. By only asking a few questions, we can arrange Medical supplemental plans with the right dental options for your needs. Contact one of our specialists today for more information.


Categories: Medicare Articles, Medicare Coverage, Medigap Coverage
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