Dental care is the number one health care service people skimp on. Because Medicare doesn’t cover dental care and dental care can be quite expensive, many older Americans tend to forego it. We either cannot afford it or do not realize how critical it is to preventing tooth decay, gum disease and loss of teeth.

So, how can Medicare beneficiaries get dental care?

Today, only one in eight seniors has dental insurance, according to a new Johns Hopkins Bloomberg School of Public Health article published in Health Affairs. Most of those who dental insurance either are still working and have insurance through their employer or are covered through a generous retiree plan. But those of us without dental insurance too often don’t see the dentist every year. The lower our income, the less likely we are to visit the dentist.

The typical person with Medicare spends $427 on dental care in a year, most of which is out of pocket. But one in 14—seven percent—spend more than $1,500 on dental care in a year.

Dental Care Through Medicaid

Seniors with low incomes sometimes can get dental care through Medicaid. But dental care is not a required Medicaid benefit. So whether as a low-income senior you can get dental care depends upon where you live. In another Health Affairs article, Susan Jaffe reports that in 2015, only 33 states covered emergency dental care for older adults with Medicare and Medicaid needing a tooth removed or treatment for extreme pain, as well as preventive and restorative dental care. Eighteen states covered dental care but only to older people with Medicare and Medicaid who needed emergency extractions or some kind of treatment for pain relief. And in 26 states, older adults with Medicare and Medicaid have coverage for dentures. Unfortunately, even when Medicaid covers dental care, people can struggle to find providers who’ll accept Medicaid’s rates.

To view a 2012 list of states and the dental services each covers under Medicaid, click here. For a more recent list, click here to open a PDF and scroll to page 7.

Low Cost Clinics with Dental Care

You may be able to get dental care through the Health Resources and Services Administration. HRSA oversees health centers and in December allocated $156 million to 420 clinics to increase their delivery of dental and oral health services in 47 states and Puerto Rico.

Or, free or low-cost dental care might be available to you at one of the 1200 free and charitable health clinics across the United States. If you qualify for care, you could also get lower-cost prescriptions through these clinics, as well as lower-cost primary medical care. Some clinics also offer mental health care. For more information about these clinics. Click here to read more about these clinics.

And, if you live in California, you might be able to take advantage of the Virtual Dental Home system of care, which the University of the Pacific is piloting. Through this program, older Californians are receiving dental care where they work, where they live and where they receive social services.

• For more resources and cost savings, see “Affordable Care for Senior Teeth” on SeniorPlanet.org
• A version of this article, “How to get dental care if you have Medicare” was first published at JustCareUSA.org