Here’s how most people find out. They turn 65, sign up for Medicare, feel pretty good about it, and then a crown or a cracked molar shows up with a bill attached. That’s when they learn Original Medicare doesn’t do routine dental.
Cleanings, fillings, extractions, dentures, Parts A and B skip all of it. Medicare only steps in for dental work tied to a covered medical treatment, like a dental exam before certain heart or transplant surgeries, or repairing your jaw after an accident. Everyday dental care is on you.
So where do Coloradans actually get dental? Three main places.
A Medicare Advantage plan. Most Advantage plans sold in Colorado include some dental, often cleanings and X-rays with little or no cost, and some add fillings, crowns, or dentures. The catch is the yearly maximum, which caps what the plan will pay for dental in a year, and the dentist network. We look at both with clients all the time, from the Front Range to Colorado Springs Medicare folks, because a plan can look generous until you price out a bridge.
A standalone dental plan. If you’d rather stick with Original Medicare plus a Medigap policy, you can add a separate dental policy. Just know that many have waiting periods before bigger work like crowns is covered, so it pays to buy before you need it.
State help for lower incomes. Health First Colorado, the state’s Medicaid program, includes adult dental with a yearly limit. And Colorado runs a senior dental program for people 60 and up with limited income who don’t have dental coverage anywhere else, offered through participating dentists and clinics.
If you’re still sorting out the bigger picture, our look at what Medicare costs at 65 covers the basics.
One last tip from our side of the desk. If you know dental work is coming, tell us before you pick a plan. A plan with a higher dental max can be worth a slightly higher premium, and that math looks different in Denver than it does for Medicare on the Western Slope, where networks can be thinner.