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What Dental Services are Covered by Medicare


If you’re a Medicare beneficiary, you might wonder if dental services are covered. Unfortunately, Original Medicare doesn’t cover routine dental. But, you can buy a dental plan alongside Medicare to pay for cleanings, exams, and dental care. Another option is an Advantage plan with dental benefits. 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?

Medicare doesn’t cover routine dental care such as cleanings, fillings, root canals, and extractions. Part A and B will only cover dental services if they’re necessary for another medical procedure. For example, Part B may pay for a dental exam before a kidney transplant or heart valve replacement. Further, Part A covers tooth extractions as part of reconstructive jaw surgery after an accident. Almost all dental care falls outside these narrow exceptions.

If you want help paying your dental bills, you have three options:

  • A Medicare Advantage plan, including dental coverage
  • A standalone dental plan
  • A dental discount plan, which isn’t insurance, but gives you a discount on services

Does Medicare Cover Oral Surgery?

Some dental plans cover gum surgery. If you have one of these plans, you’ll probably have to pay a percentage of the bill. Most dental plans also will only pay up to a certain amount in claims each year. If you’re having dental surgery because of an accident or jaw cancer, Medicare may cover your surgery.

Does Medicare Cover Dentures?

Medicare doesn’t cover dentures, but some dental plans do. Insurance may not pay 100% of dentures’ cost, but it can help lower the bill. If you need dentures, look for a plan that includes denture coverage.

Does Medicare Cover Dental Implants?

Some Medicare dental plans cover dental implants. Implants can be an excellent alternative to dentures. You can, however, expect to pay part of the cost of any major dental work. Your dental plan may have a limit on the amount it will pay out in claims each year.

Does Medicare Cover Wisdom Teeth Removal?

Medicare won’t pay for wisdom teeth removal, but some dental plans will. As with any other major dental procedure, you’ll probably have to pay part of the cost.

Does Medicare Cover Oral Exams?

No, Medicare won’t cover an oral exam. But, some companies sell Medicare dental plans – either alone or bundled with Advantage. Each company is different, and some only carry benefits. Even the most basic plans should cover preventive services like dental exams and x-rays. Sometimes you’ll have a copay.

Your insurance may pay the full cost of an exam, or you may have to pay part of the bill. Your plan may also require you to choose a primary dentist or use the dentists in the network.

If you need a dental exam because you’re having a kidney transplant or heart valve replacement, Part B may cover your exam, but it won’t cover any dental work you need.

Does Medicare Cover Teeth Cleanings?

Medicare won’t cover dental cleanings. But, basic dental cleanings are a service that most dental plans cover. A dentist may suggest an in-depth cleaning if you have gum disease or haven’t had your teeth cleaned in a while. Most likely, you’ll pay more for these types of cleanings.

Does Medicare Cover Invisible Aligners?

Invisible aligners like Smile Direct Club help straighten teeth but aren’t as noticeable as braces. Medicare won’t cover invisible aligners. But, some insurance companies usually treat aligners the same as braces. If your dental insurance includes orthodontic work, it will typically cover aligners.

With that said, it may be hard to find insurance that includes adult orthodontic coverage. If you do, you can expect to pay a percentage of the cost. Another option is to buy into a dental discount program that offers a discount on aligners.

Does Medicare Cover a Root Canal Treatment?

Original Medicare doesn’t cover root canal treatments. Advantage plans with dental coverage often include partial or full coverage for such procedures. You’ll likely have to use a dentist in the Advantage plan’s network.

Does Medicare Cover an Abscess Tooth?

An abscess is an infection in your gum or at the root of a tooth. If you develop an abscess, your dentist may perform a root canal treatment or pull the tooth. The dentist may also prescribe antibiotics. Many dental policies cover root canal treatments, but you’ll have to pay part of the cost. Your Part D plan should pay for antibiotics your dentist prescribes. If the infection spreads and becomes more severe, Part B will cover a doctor’s care, and Part A will cover hospitalization.

Does Part C Cover Dental?

Some Advantage plans include dental insurance, and others don’t. Coverage can vary. Some plans cover only standard services, and others cover a wide range of dental procedures. Research plans, so you understand what’s included before signing up. Advantage plans often include vision and hearing benefits as well.

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. Most oral surgery isn’t covered. 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 an Advantage plan covering dental, your plan may cover extractions.
Does Medicare Part B cover dental?
Part B only covers a few types of dental work that are essential for another procedure, like reconstructive surgery after a car accident.
Do Medicare Supplements cover dental?
Medicare Supplements cover the same procedures as Medicare. Since 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

Many people find dental bills go up as they get older. Crowns, extractions, gum surgery, implants, and dentures are costly. A good dental plan can help you stay on top of cleanings and make it easier to afford major procedures.

Dental plans can cost as little as $9 and range to $63+ per month. However, the average plan is about $35 per month. Humana dental plans are some of the most popular among seniors on Medicare.

Also, an indemnity solution we offer costs about $1 a day and there are no networks for dentists, audiologists, or optometrists. To learn about the details, give us a call at the number above.

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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Lindsay Malzone

Lindsay Malzone is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

20 thoughts on “What Dental Services are Covered by Medicare

  1. 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.

    1. Hi Bernadette, Medicare will only cover the dental procedure if it’s necessary for another medical procedure.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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?

  8. 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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