In most cases, Medicare does not include dental coverage. However, Medicare beneficiaries can still cover dental services by getting dental insurance from other providers.
Some Medicare Advantage plans may include dental care as an additional benefit.
For those unable to enroll in stand-alone dental insurance, there are other low-cost ways to find dental care.
Oral health is important for overall health, which is why having dental benefits matters. Regularly getting oral exams and other routine dental care and preventive services help keep people, particularly most seniors, in good health. However, do Medicare plans offer dental coverage?
When it comes to Original Medicare, dental services are generally not covered. In fact, the federal Medicare program has excluded dental services from Medicare coverage since 1980, as part of the initial Medicare program.
However, some Medicare Advantage (MA) plans do offer additional health benefits, including those for dental, vision, and hearing. Medicare beneficiaries also have the option to purchase separate dental plans.
Does Medicare Cover Dental Care?
Original Medicare does cover routine dental services. This includes dental services such as dental procedures, dental care, or dental supplies. These include but are not limited to:
Various dental devices
As such, without other forms of health insurance or dental insurance, Medicare beneficiaries can expect to cover the full cost of any dental care that isn’t covered. This means dental care costs can add up rather quickly.
However, Medicare will pay for certain dental services so long as they are directly related to a Medicare-covered procedure. For example, dental work needed for jaw reconstruction (covered procedure) following an accident would be covered. Another example would be tooth extractions to prepare for radiation treatment for neoplastic diseases involving the jaw. However, Medicare will not cover dentures that may be needed after getting teeth pulled.
Note: Learn more about Medicare and dental coverage exemptions at the Center for Medicare and Medicaid Services (CMS).
Do Medicare Advantage Plans Include Dental Insurance?
Medicare Advantage plans, also known as Medicare Part C or MA plans, are offered through private insurance companies that are approved by Medicare. A Medicare Advantage plan will bundle both Medicare Part A (hospital insurance) and Medicare Part B (medical insurance).
A Medicare Advantage plan may also provide coverage for additional health services, including dental, vision, and hearing. Some MA plans may also include prescription drug coverage, known as Medicare Part D.
Note: Learn more about MA plans and Medicare Advantage enrollment at this resource.
Dental coverage via MA plans is usually quite basic and includes services such as:
It is important to note that dental insurance, regardless of its origin, will usually have limits on the number of covered services allowed each year, maximum cost allowances, and other stipulations. In addition, different insurance policies may cover different dental services, therefore, enrollees should always check with their provider to receive the most accurate benefit information. Medicare Advantage beneficiaries should always consult with their insurance company to confirm any coverage.
Do Medigap Plans Help With Dental Coverage?
Like Original Medicare, Medigap or MedSupp plans also do not provide dental coverage. This is because these types of Medicare supplement plans are meant to supplement covered services under Medicare, not uncovered services, such as dental care.
That said, Medicare beneficiaries do not usually need a primary care physician (PCP) referral to access dental care.
How to Pay For Dental Care
If a Medicare beneficiary does not have dental coverage through an MA plan, there are a number of ways to still be covered for dental or afford dental services such as stand-alone plans, walk-in clinics, and more.
Stand-Alone Dental Plans
Patients can always purchase a separate or stand-alone dental plan for private dental coverage. This may require an additional monthly premium payment.
Walk-in Dental Clinic
Walk-in dental clinics accept clients without dental coverage. These clinics can provide affordable dental care from dental professionals.
Dental schools accept clients without dental insurance, and may offer low-cost or free dental care.
Contact the State Health Department
Your state health department may have information on how to find low-cost dental services near you.
Health Savings Account (HSA)
Opening an HSA account when you’re below 65 is a great way to save money on dental care and other services since it’s already been set aside.