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Does Medicare Cover Root Canals


Does Medicare Cover Root Canal?

A root canal is a dental procedure that aims to treat an infected tooth root by eliminating the bacteria in the canal. This is a standard procedure to prevent future root infections or tooth extraction. 

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Unfortunately, Original Medicare does not cover routine root canal procedures. Original Medicare (Medicare Part A and Part B) does not offer coverage for routine dental exams or dental procedures. Original Medicare only provides coverage for dental care if it is necessary as part of treatment for a more significant health issue, and a physician deems the procedure medically necessary. 

Even though Original Medicare does not cover the procedure, you still have options for coverage.

Below, we review the dental coverage options available to those on Medicare and how these benefits can save you hundreds of dollars at the dentist during your next root canal procedure.

How Much Does Root Canal Cost?

Undeniably, the need for a root canal is accompanied by intense mouth pains. The only way to relieve this pain is to receive the necessary root canal procedure. A root canal is usually not a painful procedure. However, the pain associated with needing a root canal can be tremendous and makes having dental coverage essential. On average, the cost of a root canal without dental coverage can be more than $1,000.

With coverage, your out-of-pocket costs for a root canal can be as low as $200-$500, depending on your plan’s benefits. However, ensuring you have coverage well before you need it is key. Often, dental plans have a waiting period before you can use their primary benefits.

While Original Medicare does not offer coverage for root canals, Medicare Advantage and additional dental plans are available to beneficiaries as coverage options.

Does Medicare Advantage Cover Root Canal?

Some Medicare Advantage plans, also known as Medicare Part C, offer beneficiaries dental coverage in addition to their health benefits. Medicare Advantage plans often have low monthly premiums and high maximum-out-of-pocket costs.

When using the dental benefits, you must ensure your preferred dentist is in your plan’s network. Once you find a dentist in your area, you may be responsible for a deductible or copayments for your root canal procedure.

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Does Medicare Supplement Cover Root Canal?

Medicare Supplement plans, also known as Medigap plans, do not offer coverage for dental services. These Medicare Supplement plans only pay secondary to Original Medicare. So, if Original Medicare does not pay for a service, neither will a Medicare Supplement plan.

However, if you prefer a Medicare Supplement plan and want dental coverage as well, you still have options. Many Medicare Supplement plan enrollees also enroll in a dental, vision, and hearing plan that offers additional, bundled coverage to Original Medicare beneficiaries. There are several carriers and available dental plans so finding the right plan for you can be confusing without help.

The easiest way to find the right plan is by speaking with a licensed agent who is fluent in Medicare. An agent will be able to go through all your healthcare needs and assess which plan is best for you.

Does Medicare Part D Cover Root Canal?

Medicare Part D helps cover the cost for many prescription drugs. Since Medicare Part D does not provide any medical coverage, the only part of a root canal procedure that Medicare Part D may cover is the medication you would be prescribed for after the procedure.

How to Enroll in Medicare Dental Coverage

Even if you are not going to the dentist regularly, it is still important to have dental coverage in case of an emergency. Also, if you have coverage, attending annual dental exams can help prevent major dental issues in the future that could lead to other health issues.

If you need help understanding the different types of dental coverage and what will work best with your health plan, give our agents a call. We are here to educate you on all things Medicare, including dental coverage.

If you can’t call today, you have other options. Complete our online rate form and one of our expert agents will reach out to you.

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Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

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