What to Know About Medicare and Dentures

• Original Medicare does not cover most dental care, including dentures or any services related to dentures, such as consultations with a dentist or surgeries recommended beforehand. 
• Some Medicare Advantage plans cover dentures as part of additional comprehensive dental coverage. 
• There are other ways to cover the cost of dentures, including a health savings account (HSA), Veterans Administration (VA) benefits, and private dental plans. 

1 in 8 Americans over the age of 65 has complete tooth loss. Tooth loss can impact someone’s ability to speak or eat a healthy diet and may lower self-esteem. Dentures (false teeth replacements) can help someone regain the self-confidence, diet, and speaking ability they had before losing all or some of their teeth.

Dentures can also be quite pricey, ranging from $500 to over $15,000. Unfortunately, this cost isn’t covered by Original Medicare. However, some Medicare Advantage plans with dental coverage do cover the cost, and there are other ways to reduce the price. To learn more about budgeting for dentures, continue reading. 

Original Medicare covers many healthcare expenses, such as hospital stays and appointments with a primary care provider. Where it’s lacking, however, is in dental coverage, despite the fact that oral health is closely related to overall health.

Technically, Medicare offers limited dental benefits, including some inpatient dental services and outpatient services that are directly related to another condition. Inpatient hospital services covered by Part A may also include some dental services, such as an emergency dental procedure related to a traumatic injury. 

Specific examples of dental services covered by Medicare include:

• An oral exam and any necessary dental procedures before a heart valve replacement
• Tooth extractions to treat a mouth infection before chemotherapy
• Dental treatment caused by complications during head and neck cancer treatment
• Dental ridge reconstruction due to tumor removal
• Dental services related to a jaw fracture
• Dental splints caused by dislocated jaw joints

If treatment for dental or oral complications is covered, Medicare pays for ancillary services and supplies, such as anesthesia administration, diagnostic x‑rays, and the use of an operating room. 

What Medicare Doesn’t Cover

The list of covered dental services is much shorter than what most people need to keep their teeth healthy. At this time, Medicare doesn’t offer coverage for:

• Routine dental care/​oral care
• Fillings
• Root canals
• Tooth extraction unrelated to another condition or treatment
• Teeth replacement
• Routine teeth cleaning
• Dental implants
• Treatment for structures that support the teeth, such as the gums

Note: all of the above are not covered in the majority of cases. If they are related to another condition or treatment covered by Medicare, they may be covered, though this isn’t always the case.

Original Medicare doesn’t cover dentures or related services, including tooth extractions, appointments with dental professionals to discuss dentures, or any other surgery to prepare the mouth for dentures.

Specific surgeries related to dentures that Original Medicare doesn’t cover include:

• Alveoplasty: surgery to reshape the alveolar process, the bone ridge that contains tooth sockets.
• Dental ridge reconstruction: reconstruction of the dental ridge, often after the removal of dental implants.
• Frenectomy: removal of tissue that connects the tongue to the mouth floor and the gums to the lips.
• Torus palatinus removal: torus palatinus is a bony growth on the mouth that should be removed so dentures fit more comfortably.

While traditional Medicare doesn’t cover dentures, most Medicare Advantage plans offer some dental coverage. Medicare Part C, or Medicare Advantage, is a plan in which individuals who qualify for Medicare elect to receive coverage through private insurance companies approved by Medicare rather than the federal government. 

While Medicare Advantage providers are required to cover Medicare Part A (hospital insurance) and Medicare Part B (outpatient care), they may also offer additional benefits, such as dental coverage. In 2024, 97 percent of private Medicare Advantage plans provide dental coverage, which may include services like dentures, according to research conducted by KFF.

But dental coverage doesn’t always include dentures. That 97% statistic refers to plans with any dental coverage, and it’s unclear how many MA options cover dentures and related expenses, such as consultations with a dentist or surgeries to prepare the mouth. However, these plans do exist if you know how to find them.

Tips to Choose a Medicare Advantage Plan that Covers Dentures

Choosing a Medicare Advantage plan that covers dentures requires careful analysis of plan benefits and the vocabulary used in MA policies. Usually, a Medicare Advantage plan will define whether it covers preventive dental services, comprehensive dental services, or both. 

Preventive care is that which ensures teeth and gums are healthy, such as oral exams, teeth cleanings, and dental x‑rays. Comprehensive services include additional services to treat dental problems or maintain teeth and gum health. Treatment of gum disease and tooth extractions both fall into the latter. Dentures would also fall under comprehensive services, though it isn’t always covered, even if a plan states they offer comprehensive dental coverage.

To confirm if comprehensive dental services include dentures, use free tools such as the Medicare Advantage comparison tool. A licensed insurance agent or local SHIP office can also help interpret plan options and answer any questions.

If a Medicare Advantage plan doesn’t directly cover dentures, it may offer a flex card that can cover some or all denture costs. A Medicare Flex card is a benefit provided by some MA providers. Flex cards are preloaded with a set amount and can be used on any pre-approved healthcare costs.

To determine if a Medicare Advantage plan includes a Flex card, and the specific healthcare benefits it can cover, speak with the Medicare Advantage provider directly or with a licensed insurance agent.

Note: A Flex card is not a required component of Medicare coverage and is not offered by Original Medicare. It is an additional benefit of some Medicare Advantage plans. 

Individuals enrolled in Original Medicare can also opt into a Medicare supplement plan to cover out-of-pocket costs. Like Medicare Advantage, supplement plans are offered by private insurance companies. Unlike Medicare Advantage plans, they cover predetermined out-of-pocket costs. 

Covered services depend on which ​“lettered” plan someone signs up for. Eleven types of Medicare supplement plans are currently offered: A, B, C, D, F, G, K, L, M, N and Medicare SELECT. Not all are available in each state, and some are unavailable to new Medicare members. While these plans vary in coverage and cost, they share one trait: none offer dental coverage. 

However, when someone enrolls in a Medicare supplement plan, the medical insurance provider may offer additional dental coverage for an extra premium. When selecting a private supplemental dental plan, a licensed insurance agent or a SHIP representative can help choose the best one. 

Medicaid, a joint state and federal-run program, provides healthcare to millions of Americans, including some who are ​“dual eligible” for Medicare and Medicaid. If someone is dual eligible, Medicare acts as the primary insurer and Medicaid as the secondary insurer. 

Determining what Medicaid covers, however, is more difficult since coverage varies from state to state. All states must provide dental coverage for those on Medicaid who are under 21 years old. For those over 21, there is no dental coverage requirement set by the federal government, and less than half of states cover any dental services, including coverage for dentures. 

When someone’s Medicare plan doesn’t cover dentures, there are out-of-pocket costs to consider. Partial dentures can cost as little as $500 while full dentures costs can go up to $15,000 or more. The exact price varies greatly, depending on how long the dentures are expected to last and the manufacturer.

While dentures cost a significant amount upfront, they aren’t a one-and-done purchase. Adults with dentures also need to budget for:

• Denture relining: a dentist completes this procedure every one to two years to check denture stability. 
• Adjustments: if a patient’s mouth changes and dentures need adjusted or replaced, a dentist will provide this service for a fee.
• Teeth extraction: sometimes, unhealthy teeth need to be extracted before an individual invests in partial or full dentures.
• Surgeries related to dentures: to make sure dentures are comfortable, dentists may recommend surgeries before fitting a patient for dentures.
• Denture adhesive: if dentures move too much, dental adhesives can keep them in place. 
• Denture care product: similar to a retainer or hearing aid, dentures should be cleaned regularly. A dentist should recommend the right care products for a specific denture model and budget.
• Appointments with the dentist: the CDC recommends continued routine dental services, such as regular check-ups and cleanings, even for individuals with dentures. 

Additional service costs vary greatly, depending on an individual’s geographical location, how much a dentist charges, the chosen denture model, and how those dentures fit in someone’s mouth. For a more specific budget, contact a local dentist.

For individuals without coverage through a Medicare Advantage plan, there are other ways to pay for dentures. Some of the most common include:

• Private dental plans: these are offered either in tandem with a Medicare supplement plan or as a standalone offering.
• Dental savings programs: Some walk-in dental clinics or dental schools that provide more affordable care or a dental discount program.
• Health savings account: a financial account where someone can set aside pre-tax money specifically for healthcare costs, including dentures. 
• VA coverage: the VA offers dental care, including denture coverage, to veterans who qualify for VA benefits. 

Dentures are costly but they can also transform someone’s self-esteem, diet, and dental health. If an individual could benefit from dentures, there are multiple coverage options, including through some Medicare Advantage plans, private dental insurance, and other avenues.