Medicare beneficiaries often wonder if their coverage includes dental services. Unfortunately, Original Medicare does not cover routine dental care.
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However, when it comes to dental coverage on Medicare, you are not without options. If you decide to keep Original Medicare, you can purchase a dental plan alongside this coverage to pay for cleanings, exams, and other dental care.
Another option for dental coverage is to enroll in a Medicare Advantage plan with dental benefits. Not all Medicare Advantage plans offer dental coverage, but many do. We’re here to help you make the right decision for your dental care needs and explain when Medicare covers dental services.
Does Medicare Cover Dental Care?
Original Medicare does not cover routine dental care. Medicare Part A and Part B will only cover dental services if they are required for another medical procedure and a physician deems them medically necessary.
Additionally, Medicare Part A and Part B may cover dental work as a part of or related to an emergency. For example, Medicare would cover tooth extractions as part of reconstructive jaw surgery after an accident. However, to be clear, most dental care falls outside the narrow window of exceptions.
Medicare does NOT cover any of the following dental services or treatments:
- Oral surgery
- Dentures
- Dental implants
- Wisdom tooth removal
- Oral exams
- Teeth cleaning
- Orthodontics
- Invisible aligners
- Root canal treatment
- Abscess tooth
According to KFF.org, more than half of Medicare beneficiaries nationwide lack dental coverage. If you have Medicare and want help paying your dental bills, you have options:
- A Medicare Advantage plan with a dental coverage benefit
- A stand-alone dental plan
- Dental, vision, and hearing plans
- A dental discount plan, which isn’t insurance, but gives you a discount on services
Medicare Supplemental Dental Coverage
When enrolled in a Medicare Supplement plan, you will need to purchase a stand-alone dental plan or utilize dental discount plans to receive coverage for dental services. Because a Medicare Supplement plan is an extension of Original Medicare benefits, your plan will only cover medical costs Original Medicare leaves behind. This does not include dental coverage.
There are many great options available for those on Medicare Supplement plans who want dental coverage as well. Popular carriers for dental plans include Cigna, Manhattan Life, Aetna, and National General.
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Medicare Advantage Dental Coverage
Some Medicare Advantage plans include dental insurance, and others don’t. Dental benefits vary from plan to plan. Some plans cover only standard services, while others cover a wider range of dental procedures.
The easiest way to know what your plan covers is to do research beforehand. Every Medicare Advantage plan offers an outline of coverage available on Medicare.gov. Here, you can see what benefits your plan offers and where those benefits are accepted. You should never go into Medicare Advantage blind. Knowledge is key when enrolling in a Medicare Advantage plan.
FAQs
How to Get Dental Benefits on Medicare
Although going to the dentist is not at the top of our list of things we look forward to, it is a vital part of our healthcare. A good dental plan can help you stay on top of preventive care and can make it easier to afford major procedures.
We can help you find the policy that's best for you. From dental insurance to Medigap coverage, we can walk you through everything you need. Just call the number above or fill out our online rate form.
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Sources:
MedicareFAQ is dedicated to providing you with authentic and trustworthy Medicare information. We have strict sourcing guidelines and work diligently to serve our readers with accurate and up-to-date content.
- Medicare Dental Coverage, KFF. Accessed February 2022.
https://www.kff.org/medicare/issue-brief/medicare-and-dental-coverage-a-closer-look/ - Medicare Dental Services, CMS. Accessed February 2022.
https://www.cms.gov/Medicare/Coverage/MedicareDentalCoverage - Dental Services, Medicare . Accessed February 2022.
https://www.medicare.gov/coverage/dental-services
How may I determine from Medicare how much WOULD HAVE BEEN COVERED for a dental abscess causing a life threatening head and neck abscess that required operative drainage and extraction to treat sepsis please? The oral surgeon did not participate, and did not bill me for more than a year. I am willing to pay what he WOULD have received had he participated, but need to know what that would be. The hospital was paid in excess of $80K by Medicare. Thank you.
Hi Luise. There is no way to really know how much Medicare would’ve paid your oral surgeon to treat your dental abscess without knowing what coverage you had as well as review an itemized bill for services rendered. If you have a Medicare Advantage plan, the carrier determines how much they will pay for a service. You would have to contact your carrier to find out what they would’ve paid.