If you’re enrolled in Original Medicare—or helping a loved one figure it all out—you may be wondering: Does Medicare cover dental care? The short answer is no, not in most cases. But the full picture is a little more nuanced.
Here are five things to know about Medicare and dental coverage—and what you can do if you need help paying for routine dental care.
1. Original Medicare Doesn’t Cover Most Dental Services
Original Medicare (Parts A and B) does not cover most routine dental care. That means:
- No coverage for cleanings, exams, or X-rays
- No coverage for fillings, crowns, or root canals
This can come as a surprise, especially since oral health plays such an important role in overall health. But Medicare was designed in the 1960s, and routine dental wasn’t included in the original law.
2. Original Medicare Does Cover Dental Work in Limited Situations
While Original Medicare excludes routine dental care, there are some exceptions. Original Medicare may cover dental services that are medically necessary and tied to other covered procedures.
For example, Original Medicare might pay for:
- A dental exam before a kidney transplant or heart valve replacement
- Jaw reconstruction following an injury
- Tooth extraction if it’s required before radiation treatment for certain cancers
In these cases, dental care is covered because it’s part of a larger medical procedure—not because it’s routine.
3. Some Medicare Advantage Plans Include Dental Coverage
If you want help paying for cleanings, fillings, or dentures, a Medicare Advantage plan (Part C) may be a good option. Many Advantage plans include dental benefits as part of their coverage.
These plans are offered by private insurance companies approved by Medicare. Dental benefits vary, but some common offerings include:
- Preventive care (cleanings and exams)
- Basic services (like fillings or extractions)
- Major services (such as crowns or dentures)
It’s important to compare plans carefully. Not all Medicare Advantage plans include the same dental coverage, and some may have limits or networks.
4. You Can Buy a Standalone Dental Insurance Plan
If you prefer to keep Original Medicare and skip a Medicare Advantage plan, you can buy separate dental insurance. These plans vary in cost and coverage but may help reduce your out-of-pocket expenses.
Look for a policy that covers:
- Preventive care at 100%
- A portion of basic and major services
- Your preferred dentist, if you have one
Just keep in mind that standalone dental plans often come with waiting periods for more expensive procedures.
5. Discount Dental Plans May Offer an Alternative
Another option to consider: dental discount programs. These aren’t insurance, but they offer reduced rates on dental services for a yearly fee.
You’ll pay out of pocket, but at a discounted rate—often 10% to 60% off. This may be a helpful alternative if:
- You don’t want to switch to a Medicare Advantage plan
- You need dental care now and don’t want to wait for a new insurance policy to kick in
- You’re looking for affordable help with routine or emergency dental costs
The Bottom Line
While Original Medicare doesn’t cover routine dental, you still have options. Whether you’re comparing Medicare Advantage plans, shopping for standalone dental insurance, or exploring a discount program, there’s a path that can work for you.
Need Help Reviewing Your Medicare Options?
Our licensed Benefit Consultants can walk you through your Medicare options and help you find coverage that includes the dental care you need. Schedule your free consultation today—no pressure, just clear answers.