Does Medicare Cover Dental Care?

One of the most common questions Medicare beneficiaries ask online is, “Does Medicare cover dental?” The answer is no. Medicare does not cover routine dental care, dental procedures, or supplies offered by dentists. Medicare beneficiaries should not expect coverage for dental services such as cleanings, fillings, tooth extractions, dental implants, dentures, etc.

However, in this article, we will discuss a few situations in which dental services and Medicare interact with each other. We will also show you another way to cover your dental care costs.

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Medicare only covers dental procedures during an emergency or a serious medical condition like cancer.
Medicare does not cover routine dental care, dentures, or other non-emergency dental services.
Medicaid can provide help with tooth extractions in certain states but not routine dental care.
Some Medicare Advantage plans cover dental services as part of their expanded services.
An alternative to dental insurance would be dental savings programs.
Dental savings programs will save their beneficiaries a flat discount, averaging 40-60 percent, on the costs of most dental treatments.

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Dental Coverage for Seniors

Due to the limitations with dental benefits through the Medicare program, millions of Americans do not receive routine dental services. Preventive dental care can affect overall health, especially as people grow older. This is why it is important for everyone to have a dental insurance plan.[mfn referencenumber=1]KFF.org, “Drilling Down on Dental Coverage and Cost for Medicare Beneficiaries“, Accessed November 17, 2021[/mfn]

The difficult fact is that there’s virtually zero government assistance available for Medicare beneficiaries who need dental care, including those who can’t afford to pay for it. Both Medicare and Medicaid do not offer complete oral healthcare coverage for seniors. Medicaid, in some states, has provisions that cover extractions of teeth, but completely exclude the most common oral care we all need as we age. There’s literally no help when it comes to replacing missing teeth and dealing with periodontal disease.[mfn referencenumber=1]KFF.org, “Drilling Down on Dental Coverage and Cost for Medicare Beneficiaries“, Accessed November 17, 2021[/mfn][mfn referencenumber=2]Medicaid.gov, “Dental Care“, Accessed November 17, 2021[/mfn]

Does Medicare Part A Cover Emergency Dental Care?

In certain circumstances, Medicare Part A can pay for inpatient hospital care if you need to have emergency or complicated dental procedures. Generally speaking, Medicare only covers dental care that’s required as part of your overall inpatient treatment.[mfn referencenumber=3]Medicare.gov, “Dental Services“, Accessed November 17, 2021[/mfn].

Let’s say you’re in a car accident and suffer oral injuries. Medicare Part A can pay for the dental procedures necessary to repair the damage. The same would be true of dental care required in conjunction with cancer treatment or another serious illness. The caveat is that the dental services must be directly related to the reason for inpatient care.[mfn referencenumber=3]Medicare.gov, “Dental Services“, Accessed November 17, 2021[/mfn]

Medicare may allow some dental coverage when beneficiaries are an inpatient in:[mfn referencenumber=4]Medicare.gov, “Inpatient hospital care“, Accessed November 17, 2021[/mfn]

Acute Care Hospitals
Critical Access Hospitals
Inpatient Rehabilitation Facilities
Long-Term Care Hospitals
Inpatient Care for Research Purposes
Mental Health Care

Does Medicare Part B Cover Dental Services?

There’s confusion about Medicare Part B and dental coverage. Medicare Part A covers dental procedures during an emergency and Medicare Part B provides coverage for necessary dental services as part of a medical procedure.[mfn referencenumber=5]Medicare.gov, “What Part B Covers”, Accessed November 17, 2021[/mfn]

Medicare covers dental services when someone needs an oral exam before a kidney transplant, cancer treatments related to the mouth, or requires extractions before receiving radiation treatment near the mouth.[mfn referencenumber=5]Medicare.gov, “What Part B Covers”, Accessed November 17, 2021[/mfn]

Medicare coverage does not apply to routine dental care services such as:[mfn referencenumber=3]Medicare.gov, “Dental Services“, Accessed November 17, 2021[/mfn][mfn referencenumber=1]KFF.org, “Drilling Down on Dental Coverage and Cost for Medicare Beneficiaries“, Accessed November 17, 2021[/mfn]

Cleanings
X-Rays
Fillings
Crowns
Dental implants
Dentures

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Medicare Advantage Plans – Part C

Although Original Medicare does not offer routine dental coverage, a growing number of Medicare Advantage plans do. Coverage can range from basic checkups, cleanings, and other routine care to full coverage.

Medicare Advantage plans are private health plans, similar to those offered by an employer or Obamacare. Plans must offer all of the benefits covered by Original Medicare, but they can also include additional benefits, such as dental, vision, and hearing. [mfn referencenumber=6]Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed November 17, 2021[/mfn]

The best way to find a Medicare Advantage plan with the level of dental coverage you need is to get on the phone with an advisor.

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Traditional Dental Coverage Is Not the Only Option for Seniors

If you don’t have dental insurance coverage through an employer, a Medicare Advantage plan, or a stand-alone plan, and you can’t afford to get one, there’s another good option. It’s the dental savings plan, often called discount dental. It’s not insurance, and it’s not meant to be. It’s a guaranteed discount, typically in the range of 40-60 percent, on all of the common treatments you need.[mfn referencenumber=7]Cigna.com, “Discount Dental Programs“, Accessed November 17, 2021[/mfn]

Dental Savings Plans

Here are five recommended dental savings plans (DSPs) offered for people who need help with dental costs:

The following table demonstrates common savings using a popular DSP from Cigna, one of the largest names in healthcare:

Dental Procedure	ADA Code	Price w/o DSP	Price w/ DSP
Four Routine 6 Month Check-Ups	D0120	$192.00	$96.00
Two Full Mouth X-Rays	D0210	$256.00	$140.00
Two Adult Teeth Cleanings	D1110	$184.00	$108.00
Two Bitewing – Single Radiographic Image	D0270	$60.00	$26.00
Two Full Upper Dentures	D5110	$3,074.00	$1,556.00
Single Crown – Porcelain On High Noble Metal	D2750	$1,065.00	$594.00
Tooth Replacement Part Of Permanent Bridge	D6210	$1,053.00	$559.00
	*You Pay:*	$5,884.00	$3,079.00

As you can see, the savings are substantial. Plus, unlike dental insurance, there’s no annual or lifetime cap on benefits, no waiting period to use benefits, and no hassle with claims forms. You can see all of the discount dental plans available where you live here.

In Summary

Routine dental care is crucial for a person’s health and wellbeing. Not only can tooth and gum damage affect other aspects of your health, but it affects your quality of life being unable to eat and speak without issue. Since Original Medicare will not cover most dental services, consider enrolling in a Medicare Advantage plan with dental. Or better yet, a dental savings program that will discount a flat rate of your most common dental care needs.