Does Medicare Cover Dental Care?

Updated on: August 27th, 2020

Reviewed by Diane Omdahl

We aim to help you make informed healthcare decisions. While this post may contain links to lead generation forms, this won’t influence our writing. We follow strict editorial standards to give you the most accurate and unbiased information.

For the most part, Original Medicare (Medicare Part A and Part B) does not cover dental care. But there are exceptions to this. Here’s what you need to know about Medicare’s dental coverage and how you can get the dental care you need.

What Does Medicare NOT Cover?

Original Medicare (Medicare Part A and B) does not cover dental care. So assume you’ll pay 100% out-of-pocket for dental procedures like cleanings, tooth fillings, extractions, dentures, and implants.1

There are a few exceptions to this, though. Medicare Part A might cover some dental care if it is related to the reason you’re hospitalized, or if the dental issue is connected to another condition that needs treatment. Original Medicare will also cover dental examinations required before specific surgical procedures.2

Original Medicare Does Not Cover These Forms of Dental Care:

Routine Services

  • Cleaning
  • Dental exams
  • Fillings
  • Crowns
  • Bridges

Dental Procedures

  • Extractions
  • Root canal treatments
  • Periodontal treatments

Dental Prosthetics 

  • Dentures
  • Dental plates
  • Dental implants
  • Crowns

What Does Medicare Cover?

Situations When Medicare Covers Treatment

Original Medicare may not cover routine dental care, but there are a few instances where it will meet your needs.

Part A: Hospital Stays 

If you’re in the hospital for an injury or illness, Medicare Part A (hospital insurance) may cover dental care you receive during your stay. 

For instance, if you fracture your jaw in an accident and are hospitalized, Medicare will cover your jaw reconstruction and the related extractions.3 But Medicare will not cover any follow-up dental care related to the jaw reconstruction that you might need in the future.4

Medicare Part A may also cover the cost of your inpatient care if you need to be hospitalized to have an emergency or complicated dental procedure. This means that Medicare will pay for the cost of your hospitalization (room, board, observation, X-ray, etc.). However, the actual dental service will not be covered. Say you have a clinical condition that requires you to be under observation during a tooth extraction. In this case, the cost of your inpatient stay and observation will be covered, but not the extraction.5

Inpatient care includes treatment you receive at any of these locations:6

  • An acute care hospital
  • A critical access hospital
  • An inpatient rehabilitation facility
  • A long term care hospital

Inpatient care you receive as part of mental health care or an eligible research study qualifies too. 

Medicare will also pay for preparatory tooth extractions needed before radiation treatment for oral cancer (or other conditions involving tumors in the jaw).

Exam

Medicare will pay for any oral or dental examination you need before a kidney transplant or heart valve replacement. For Part A to cover it, the exam has to be performed by a dentist working for the hospital where you’re being treated.7

Part B: Exam

Medicare Part B will cover required dental or oral examinations before a kidney transplant or heart valve replacement, if the exam is performed by a physician.

What Are My Options for Dental Care?

Almost all adults (96%) over the age of 65 have had a cavity, and another 68% have gum disease.8 This makes it likely that, even if it’s only preventative, you’ll need some form of dental care.

With dental care insurance, there’s a wide range of costs and benefits, depending on a few different factors. Shopping for coverage might seem overwhelming. Here are some basics on the different options available to you.

Medicare Advantage

Besides providing Original Medicare benefits, many Medicare Advantage plans offer extras like dental coverage. 

Costs

Costs vary from plan to plan. Many plans that offer dental benefits require you to pay extra monthly premium costs to access those benefits. Others don’t require you to pay anything outside the regular monthly premium.

Annual health plan deductibles range from nothing to $1,000 or more.

Coverage

Coverage also varies from plan to plan. Some Medicare Advantage plans only offer preventive and routine benefits like cleaning, oral exams, fillings and dental X-rays. Other plans, in addition to routine services, offer comprehensive dental benefits like extractions, periodontics, and endodontics.

Use Medicare’s Plan Finder to see what’s offered by the Medicare Advantage plans in your area.

Stand-alone Plans

You can buy a separate insurance plan that only covers dental care. It’s useful if your current health coverage doesn’t cover dental care, or you want a different kind of dental coverage.

Many stand-alone dental plans require you to go to an in-network dentist for your care. Others may let you use out-of-network dentists for an extra fee.

Costs

Monthly premiums, copayments and annual deductibles vary widely from plan to plan.

Coverage

Coverage also varies widely. Most plans will cover routine dental care, but coverage for more comprehensive services will differ.

Dental Discount Plans

Dental discount plans are not insurance plans. These plans give you discounts on dental services, as long as you go to an in-network dentist. 

Costs

With dental discount plans, your cost is a single, upfront annual fee. There are no copays or deductibles. You pay the dentist directly for the service(s) provided, but at a lower price.

Coverage

The discounted services vary from plan to plan.

Conclusion

Aside from special circumstances, Original Medicare does not cover dental care. You can get routine and more comprehensive dental care by buying a Medicare Advantage plan, a stand-alone dental plan or a dental discount plan.

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  1. U.S. Government Website for Medicare. “Dental services.” medicare.gov (accessed April 17, 2020).

  2. U.S. Government Website for Centers for Medicare & Medicaid Services. “Medicare Dental Coverage.” cms.gov (accessed April 17, 2020).

  3. Medicare Dental Coverage.”

  4. Medicare Interactive. “Medicare and dental care.” medicareinteractive.org (accessed April 17, 2020).

  5. Medicare and dental care.”

  6. Dental services.”

  7. Medicare Dental Coverage.”

  8. Centers for Disease Control and Prevention. “Oral Health for Older Americans.” cdc.gov (accessed April 17, 2020).