Does Medicare Cover Dental Care?

Original Medicare doesn't cover routine dental care, but there are other ways to get coverage.
Apr 19, 2022

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Original Medicare doesn’t cover most dental care, including dental exams, teeth cleanings, fillings, root canals, extractions, dentures, implants and crowns. However, you may be eligible for some services covered under Medicare Part A — your hospital insurance

.

How does Original Medicare cover dental?

The short answer is that Original Medicare (Parts A and B) doesn’t cover most dental care, including dental cleanings and fillings. In fact, nearly half (47%) of Medicare beneficiaries don’t have dental coverage, according to the Kaiser Family Foundation

. But Medicare Part A (your hospital insurance) will cover some dental services that are performed as part of an inpatient stay in a hospital.

For instance, Medicare would pay for reconstruction of your jaw after an accidental injury or tooth extractions that were required before radiation treatment involving the jaw. You would also be covered for an oral exam before a procedure like a kidney transplant or heart valve replacement, but you wouldn’t be covered for any dental treatment resulting from the exam. (Medicare Part A would cover the exam if a hospital dentist performed it, and Medicare Part B would cover it if a physician examined you

.)

Part A would also cover the cost of your hospital stay if you needed emergency or complex dental treatment, but the dental care itself wouldn't be covered.

Does Medicare Advantage cover dental care?

Medicare Advantage plans — also called Medicare Part C — usually offer extra coverage that doesn’t come with Original Medicare Part A and Part B, including some cost savings on dental care. This may include teeth cleanings, fillings, routine X-rays and extractions. Of Medicare Advantage enrollees in individual plans in 2021, 94% had access to some dental coverage, according to the Kaiser Family Foundation.

Medicare Advantage plans are offered by private health insurance companies that have been approved by Medicare.

There are various types of Medicare Advantage plans, and they offer different kinds of coverage with different cost structures. There also tends to be a maximum annual dollar cap on what a plan will pay for dental care. If you need dental coverage of a particular type, make sure the Medicare Advantage plan you’re considering offers it.

Medicare Advantage providers

Get more information below about some of the major Medicare Advantage providers. These insurers offer plans in most states. The plans you can choose from will depend on your ZIP code and county.

Does Medigap cover dental care?

Medigap, or Medicare Supplement Insurance, is an additional coverage that can be purchased by Original Medicare users to cover out-of-pocket costs like deductibles, copays and coinsurance.

Although the vast majority of Medigap plans don’t cover routine dental care, a small percentage of them offer additional benefits like vision, hearing and dental coverage

. This might come in the form of a coverage add-on and not something covered under the standard plan.

Non-Medicare dental coverage options

You don’t have to go through Medicare to get dental coverage. You can enroll in separate dental insurance coverage. Many of the major insurers — Humana, UnitedHealthcare, Aetna — offer dental coverage, and AARP offers member plans through Delta Dental.

These insurance plans operate like most insurance you may have worked with: You pay a monthly premium and have access to a number of in-network dentists for care. Depending on the plan, you may be able to go out-of-network for a higher fee, or you may not be covered for any out-of-network dentists.

Other coverage options include:

  • A dental discount plan: This is like joining a discount club (like Costco, for instance). You pay a fee to get access to a group of dentists that offer you a discounted rate.

  • Your partner’s dental coverage: If your spouse or partner has access to dental benefits through their employer, you may be able to enroll as well.

  • Your employer’s dental coverage: If you’re still working and your employer offers dental benefits, you can enroll in that plan and benefit from group rates.

Typical Medicare-age dental costs

Among Medicare beneficiaries who used dental services in 2018 (the most recent data available), average out-of-pocket spending was nearly $900, according to the Kaiser Family Foundation. One in 5 Medicare beneficiaries who used dental services spent more than $1,000 out-of-pocket, including 1 in 10 who spent more than $2,000. Dental care can be pricey, with typical costs like the following:

  • Basic cleaning: $75 to $200.

  • Panoramic X-rays: $100 to $200.

  • Dental exam: $50 to $200.

  • Amalgam filling: $50 to $150.

  • Composite filling: $90 to $250.

  • Root canal: $620 to $1,500.

  • Crown: $600 to $3,000.

  • Tooth extraction: $75 to $800.

Consequently, about 1 in 6 older adults say they didn’t visit a dentist in the previous year due to cost, according to a 2021 report from The Commonwealth Fund

. Dental insurance can help keep out-of-pocket costs down and make expenses more predictable.

How to enroll in dental coverage

How and when you enroll in dental insurance will depend on the kind of coverage you choose:

Medicare Advantage plan: If you want to sign up for a Medicare Advantage plan that comes with dental coverage, you have three chances to enroll:

  • During your initial enrollment period for Medicare, which is typically during the seven-month period that includes three months before the month you turn 65, the month you turn 65 and the three months after.

  • During the Medicare open enrollment period that happens each year from Oct. 15 to Dec. 7.

  • During a special enrollment period if you qualify due to such circumstances as a move, becoming eligible for Medicaid or getting care in a skilled nursing facility.

Separate dental insurance: You can enroll in a stand-alone dental insurance plan at any time.

Dental insurance through an employer: If you or your spouse are still working and you can get covered that way, you’ll generally have to wait for the open enrollment period (typically in the fall) to opt in to group dental coverage.

Make sure to consider things that might pop up in the future. For instance, if you have concerns about your teeth or your dentist has mentioned the possibility of dentures, look for a plan that offers denture coverage.

People who have dental coverage tend to be happy with it: Some 83% of consumers with dental insurance are either “Extremely/Very” or “Somewhat” satisfied with it, according to a 2019 survey from AHIP (a national association of health insurance providers)

. Sixty-eight percent say it saves them hundreds of dollars in out-of-pocket costs, and 65% say it eases their concerns about paying for unexpected procedures.

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