What dental procedures are covered by medicare

En español | No. Medicare doesn’t cover routine dental care, such as regular exams, cleanings and X-rays, and it also doesn’t cover most procedures related to dental health, such as extractions, root canals, dentures and other dental services. 

In fact, Medicare covers dental-related expenses in very limited circumstances, such as surgery to treat jaw fractures, dental services to prepare for radiation treatment of oral cancer or an oral exam conducted in a hospital before a kidney transplant. This is despite decades of data showing that abscesses in the mouth can lead to sepsis, a body’s overactive response to an infection that can be fatal at any age but is especially risky for adults 65 and older and children younger than 12 months. 

Does Medicare Advantage cover dental care? 

Medicare Advantage plans, the private alternatives to original Medicare, typically include dental care automatically. In 2021, only 10 percent of Medicare Advantage enrollees paid a separate premium for dental benefits, the Kaiser Family Foundation reports. Some plans will let you add another level of dental coverage for an extra premium. 

But dental benefits vary from plan to plan. Most Medicare Advantage (MA) plans cover preventive services, such as cleanings and X-rays, without having to make a copayment. Members on average pay 20 percent to 70 percent copays for dental procedures such as crowns, dentures, extractions, implants, root canals and treatments for gum disease, with 50 percent being the norm, according to the study. 

Most Medicare Advantage plans also have annual caps on dental coverage, averaging $1,300 in 2021; 8 percent of MA members were in a plan with a cap of $2,000 to $5,000 during that time. 

With such a wide range of coverage levels to choose from, it’s important to compare the plans’ dental coverage against your other medications, doctors and health care needs before selecting one that’s right for you.  

To check out plans with dental coverage in your area, go to the Medicare Plan Finder and key in your zip code. In the Plan Type drop-down menu, click Medicare Advantage Plan and hit Apply. 

You then may be asked to choose your county if your zip code spans more than one. When you click Start, you’ll first have to note if you receive financial aid and then you’ll see an option to compare drug costs among plans. This doesn’t include dental costs. 

From there, press Next and you will see a list of all Medicare Advantage plans in your area. A green check mark notes Dental in the Plan Benefits list. You can narrow the list by clicking on Filter by: Plan Benefits | Dental coverage | Apply.

For more information about the plan’s dental coverage, click Plan Details and scroll down to Extra Benefits. If a plan has copayments or coverage limits, you’ll see those listed in the Dental section. 

You also can visit a plan’s website or contact the plan directly for more information. You may be required to use an in-network provider and get prior authorization for some dental services. 

What are other ways to get help paying for dental care? 

Other sources also can help you pay for dental care:  

  • Standalone dental insurance policies. Premiums, copayments, covered services and annual coverage maximums vary a lot from plan to plan. These may require you to use an in-network dentist and wait for a predetermined time before the plan will cover more expensive procedures. 
  • Dental discount programs. Some programs charge an up-front annual fee in return for discounts on dental services, which can range from 30 percent to 40 percent off on cleanings, crowns, exams and fillings. But they also require you to use certain dentists. 
  • Extra coverage from Medigap. While standard Medigap policies exclude dental coverage, some Medigap insurers allow you to tack on dental coverage to your policy for an extra premium. This often entails membership in a dental discount program, such as certain types of dental coverage packaged with hearing and vision benefits too. 
  • Medicaid. In some states, Medicaid provides dental coverage for people who meet income and asset requirements. However, nearly half of those states provide care beyond emergency dental services for adults. Contact your state Medicaid office for details. 
  • Veterans benefits. The U.S. Department of Veterans Affairs provides dental care benefits to veterans who qualify. The type and amount of dental care you can receive is based on your service-connected disability rating, your service history and other factors. See the VA’s dental care page for more information.  

Keep in mind 

You can withdraw money tax-free from a health savings account to pay most out-of-pocket dental expenses. You can’t contribute to an HSA after you enroll in Medicare, but you can use money you’ve already saved in the account for eligible medical expenses at any age, including dental expenses not covered by insurance.