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What Dental Services Are Covered by Medicare


Medicare beneficiaries often wonder if their coverage includes dental services. Unfortunately, Original Medicare does not cover routine dental care.

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 Medigap plans are extensions of Original Medicare benefits, your policy 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.

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

Does Medicare pay for dental surgery?
Medicare only pays for dental surgery in a few specific situations, such as when you have jaw cancer or need reconstructive surgery after an accident. But, most oral surgery doesn’t receive coverage. If you have dental insurance, it may pay part of the cost of surgery. But your specific benefits will depend on your plan.
Does Medicare cover tooth extraction?
Medicare covers tooth extractions to prepare you for radiation treatment for jaw cancer. Otherwise, it won’t pay for a tooth extraction. If you have a dental policy or a Medicare Advantage plan covering dental care, your plan may cover extractions.
Do Medicare Supplement plans cover dental?
Medicare Supplement plans cover the same procedures as Original Medicare (Parts A and B). Because Original Medicare doesn’t cover routine dental services, Medigap doesn’t cover them either. But you can buy dental insurance to cover the services you need.

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:

  1. Medicare Dental Coverage, KFF. Accessed February 2022.
    https://www.kff.org/medicare/issue-brief/medicare-and-dental-coverage-a-closer-look/
  2. Medicare Dental Services, CMS. Accessed February 2022.
    https://www.cms.gov/Medicare/Coverage/MedicareDentalCoverage
  3. Dental Services, Medicare . Accessed February 2022.
    https://www.medicare.gov/coverage/dental-services

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.

30 thoughts on “What Dental Services Are Covered by Medicare

  1. I have a punctured sinus cavity that an oral surgeon has to fix. Does Medicare partially pay for this, my dental insurance will pay for the removal of my implants but not for the puncture repair.

    1. Sara, Medicare covers Medically necessary procedures. So, if a doctor has deemed this procedure Medically necessary, Medicare should cover its portion of the costs. However, it is important to speak with your doctor and consult with Medicare directly for your specific coverage options.

  2. I am on Medicare. I fell and one of my front teeth was knocked out and another loosened. Will Medicare pay for any of this trauma?

    1. Thanks for reaching out! Unfortunately, unless this fix is deemed medically necessary, it would not typically be covered.

  3. I am 72, on Medicare senior advantage with Kaiser, I’ve had open heart surgery, and diagnosed with gastroparesis, I am on a strict diet and must chew my food completely to aid in digestion I need two crowns and front teeth rebuild to begin the process of digestion if my doctors deemed it necessary will Medicare pay for it or any part?

    1. LeRoy, Medicare will cover specific dental procedures if they are considered medically necessary for another medical procedure. If dental work is required to aid in a digestive procedure, you will want to check with Medicare beforehand.

  4. I have an abscess and it’s very painful, I can’t sleep. Can I go to the dentist and have it drained and get antibiotics? I have the original medicare and Medicaid for insurances

    1. Yvette, dental care is not covered by Medicare. However, often, dental care will be covered under your Medicaid plan. You should check with the plan administrator for clarification. If not, you should contact your doctors office to see if they are able to help with your situation.

  5. I broke a 40 year old amalgam filling that consumes most of my molar….i presume i will need a crown….i have dental insurance from my husbands previous employer before he retired ….. i have Medicare and also a supplemental thru Anthem blue cross ……. do you know if i will i have any help with the co-pay thru Medicare or Anthem?

  6. Hi! I understand that Medicare will not pay for dental services. However; in the instance of someone who has a developmental disability and is bed-bound, and needs dental services completed in a hospital under anesthesia…will Medicare over the hospitalization and anesthesia portion? Thank you.

  7. Hi ,if I have had heart valve replacement and have pace maker ,and need root canal on my molar and could affect my heart if not attender to .
    Will medicare pay for my root canal and possible crown
    Thanks

    1. Hi Neville! As long as your doctor says the root canal is medically necessary and part of your treatment for your heart valve, then Medicare will cover it.

    1. Hi Catherine! You’re better off discussing the treatment with your doctor. They will know if Medicare will cover it. Unless the dental service is part of another treatment that is covered by Medicare, it most likely won’t be covered, unfortunately.

    1. Hi David! Unfortunately no. Not unless your primary care physician says the dental implants are medically necessary.

  8. I have an auto immune disease that is destroying my teeth. Will Medicare cover any of the cost to treat this ?

    1. Hi Judy! If the doctor deems that treating your teeth is medically necessary, then Medicare will cover it.

  9. I went to the ER November 27, 2020 with a abscessed tooth. I was really hurting. On thanksgiving the day before I call my dentist on call and they never gave me a call, so I had to get help I went to the ER.
    They Did full X-ray and cat scan. Never did see the ER doctor they gave me a prescription. I have Medicare and anthem supplement. I received a bill from the emergency physician for 659.00. Medicare denied payment. They paid fir every thing else. I had no choice but go to Er for help.
    The following Monday I went to my dentist and they referred me to a dental specialist and I got a root canal.
    Bottom line is don’t go to the Er fir a tooth ache doing the holidays
    I am m stuck either bill

    1. Hey John! Part A does come with an annual deductible, but if you have a Medicare Supplement plan that is most likely covered 100%. The only exception is if you have Plan K, L, or M. They pay a percentage of the deductible. Without seeing your itemized bill, it’s hard to say if the correct codes were used when billing Medicare. If you have a Medicare Advantage plan through Anthem, that’s where it can get tricky. They get to pick and choose how much of a service they will cover and your out of pocket expenses can be very hard to predict. I would reach out to either Medicare directly or the hospitals billing department to verify everything was billed correctly.

  10. I need tori removal as the bone has become pointed and is close to breaking through my gums. Will Medicare cover this surgery?

    1. Hi Ann! Medicare does not pay for the majority of dental procedures, including tooth extractions. Medicare will cover 80% of the Medicare-approved amount if it’s deemed medically necessary & performed by a Medicare-approved provider.

  11. I had a tooth abscess where 2 teeth were extracted. It did not solve the problem and my doctor believes the abscess has moved into the gum or bone. Will Medicare cover an oral surgeon to treat the problem in their office?

    1. Hi Stacey! If your oral surgeon accepts Medicare, then yes they will cover the procedure as long as it’s medically necessary.

  12. I have a molar that had abscesses. Was on antibiotics for seven days. I am on blood thinner due to afib and no one will pull tooth because my Dr. will not stop xarelto for two days. They want me to go to out patient clinic at hospital. Will medicare pay for this?

  13. 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.

    1. 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.

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