Does Medicare Cover Root Canals?
Original Medicare does not typically cover dental root canals. Medicare primarily covers medically necessary care, and dental procedures are often classified as routine services, which are not covered.
So, unfortunately, individuals relying on Medicare for their dental services may be paying out-of-pocket for root canals, which can be expensive.
However, a few alternatives may be available to those insured under Medicare. Some Medicare Advantage plans provide dental coverage, including root canals. Additionally, root canals may be covered by supplemental dental insurance plans that cover non-medically necessary services.
How Much Does a Root Canal Cost?
Out-of-pocket expenses for a root canal vary widely, depending on several factors, such as the tooth’s location, the procedure’s complexity, and the dental practice’s pricing structure.
On average, the cost of a root canal in the United States can range from $300 to $2,000 per tooth for the procedure. If a dental crown is needed afterward (which is common), this can add $500 to $3,000.
Thus, out-of-pocket costs for a root canal and crown can amount to as much as $5,000 without dental insurance. However, these numbers are estimates, and actual costs can be higher or lower based on the specifics of each case.
What if I Can't Afford a Root Canal?
Adding a standalone dental insurance plan to your Original Medicare coverage or having a Medicare Advantage plan may provide some relief for those considering root canals.
If you want to keep your health coverage with Original Medicare, your best option for dental care is to opt for a standalone dental insurance plan. Designed to reduce the cost of preventive care, such as regular cleanings and checkups, these plans may also provide coverage for primary services like fillings, crowns, root canals, dentures, and other restorative treatments.
If you have replaced your Original Medicare coverage with a Medicare Advantage plan, you may already have dental coverage included. The coverage usually consists of basic dental services such as cleanings, but it may also provide coverage for more extensive procedures like partial or complete coverage for root canals.
Still, checking the specifics of your plan’s dental benefits is crucial, as coverage options can differ significantly between providers.
Bottom Line
Medicare does not typically cover root canals, but other options may be available. If you are considering a root canal, explore all your available insurance coverage and out-of-pocket costs before making any decisions. And don’t forget to take advantage of preventive care services like regular checkups, which can often help avoid more costly treatments.
Sources: WebMD – KFF – Medicare.gov
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