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 MedicareWireMedicareWire is a Medicare insurance consulting agency. We founded MedicareWire after seeing and hearing how confusing and frustrating it is to find, understand, and choose a plan. Our services are free to the consumer.... article, we will discuss the few situations that dental services and Medicare interact with each other. We will also show you another way you can cover the costs of your dental care.
Key Takeaways
- Medicare only covers dental procedures during an emergency or a serious medical condition, such as cancer.
- Medicare does not cover routine dental care, dentures, or other non-emergency dental services.
- MedicaidMedicaid is a public health insurance program that provides health care coverage to low-income families and individuals in the United States.... can provide help with tooth extractions in certain states, but not routine dental care.
- Some Medicare Advantage plansMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B).... 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.
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.1KFF.org, “Drilling Down on Dental Coverage and Cost for Medicare Beneficiaries“, Accessed November 17, 2021
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.1KFF.org, “Drilling Down on Dental Coverage and Cost for Medicare Beneficiaries“, Accessed November 17, 20212Medicaid.gov, “Dental Care“, Accessed November 17, 2021
Does Medicare Part A Cover Emergency Dental Care?
In certain circumstances, Medicare Part AMedicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care.... 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.3Medicare.gov, “Dental Services“, Accessed November 17, 2021.
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 careInpatient care refers to care provided in a hospital or other inpatient facility. Inpatients are admitted and stay at least one night depending on their condition.....3Medicare.gov, “Dental Services“, Accessed November 17, 2021
Medicare may allow some dental coverage when beneficiaries are an inpatient in:4Medicare.gov, “Inpatient hospital care“, Accessed November 17, 2021
- Acute Care Hospitals
- Critical Access Hospitals
- Inpatient Rehabilitation Facilities
- Long-Term Carea variety of services that help people with their medical and non-medical needs over a period of time. Long-term care can be provided at home, in the community, or in various types of facilities, including... Hospitals
- Inpatient Care for Research Purposes
- Mental Health Care
Does Medicare Part B Cover Dental Services?
There’s confusion about Medicare Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare... 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.5Medicare.gov, “What Part B Covers”, Accessed November 17, 2021
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.5Medicare.gov, “What Part B Covers”, Accessed November 17, 2021
Medicare coverage does not apply to routine dental care services such as:3Medicare.gov, “Dental Services“, Accessed November 17, 20211KFF.org, “Drilling Down on Dental Coverage and Cost for Medicare Beneficiaries“, Accessed November 17, 2021
- Cleanings
- X-Rays
- Fillings
- Crowns
- Dental implants
- Dentures
Medicare Advantage Plans – Part C
Although Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage.... 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. 6Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed November 17, 2021
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.
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.7Cigna.com, “Discount Dental Programs“, Accessed November 17, 2021
Dental Savings Plans
Here are five recommended dental savings plans (DSPs) offered for people who need help with dental costs:
- Aetna Vital Dental Savings
- Cigna Preferred Network Access
- CVS iSave Dental Savings
- Careington Care 500 Series
- DentalPlans.com (1 Month FREE!)
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.
Citations
- 1KFF.org, “Drilling Down on Dental Coverage and Cost for Medicare Beneficiaries“, Accessed November 17, 2021
- 2Medicaid.gov, “Dental Care“, Accessed November 17, 2021
- 3Medicare.gov, “Dental Services“, Accessed November 17, 2021
- 4Medicare.gov, “Inpatient hospital care“, Accessed November 17, 2021
- 5Medicare.gov, “What Part B Covers”, Accessed November 17, 2021
- 6Medicare.gov, “How do Medicare Advantage Plans work?“, Accessed November 17, 2021
- 7Cigna.com, “Discount Dental Programs“, Accessed November 17, 2021