Medicare helps to cover the costs of medical expenses for people 65 and older and people with certain disabilities. However, not all medical expenses are covered by Medicare, and it is important to understand whether your Medicare plan excludes certain services.

If you require routine dental care, you may be wondering what does Medicare cover for dental? In most cases, Medicare does not cover dental unless you have a Medicare Advantage plan. However, some exceptions exist in which Original Medicare may cover some dental expenses.

Does Original Medicare cover dental?

Original Medicare includes Part A and Part B benefits. Under Part A benefits, you will be covered for inpatient health care, while Part B covers outpatient medical services. Dental benefits are not included in either Part A or Part B benefits, so Original Medicare does not cover dental.

However, in certain circumstances, you may get coverage for medically necessary dental procedures under Original Medicare. For instance, if you fall and suffer a fractured jaw, any resulting damage to your teeth may be covered by your Original Medicare plan. Dental services may also be covered if they are part of treatment for a covered illness like oral cancer.

For medically necessary dental procedures, coverage will fall under Part A benefits if you are receiving inpatient care or under Part B benefits if you are receiving patient care.

Keep in mind that Original Medicare does not cover routine dental procedures like teeth cleaning, extractions, retainers, or dentures.

2024 rules for Medicare coverage of dental services

According to Kff, recent CMS rules for Medicare introduce new clinical scenarios allowing payment for dental services.

In 2024, Medicare coverage expands to include diagnostic and treatment services for dental or oral complications following radiation, chemotherapy, and/or surgery in head and neck cancer treatment. Additionally, dental or oral examinations and treatment will be covered before or alongside chemotherapy, CAR T-cell therapy, and high-dose bone-modifying agents for cancer treatment.

Why does Medicare not cover dental?

Although many older adults require dental health services, Original Medicare does not cover them because they are not deemed medically necessary.

Dental care and medical care are typically regarded as separate by Medicare and private health insurance companies, so dental plans are usually sold as separate plans.

Does Medicare Advantage cover dental?

If you have a Medicare Advantage plan, you may receive coverage for dental services, including routine treatments like dental cleaning, extractions, fillings, and dentures. However, keep in mind that Medicare Advantage, also called Medicare Part C, is offered by private insurers, so benefits can vary widely depending on the insurer.

Medicare Advantage plans include all of your Part A and Part B benefits, and they may also offer coverages not included in Original Medicare, like dental. You should review your Medicare Advantage dental plan benefits, including what dental services are covered, copayments, and applicable limits. Keep in mind that not all Medicare Advantage plans include dental coverage.

Does Medicare Supplement cover dental?

Medicare supplement plans or Medigap are offered by private insurers to supplement Original Medicare. Medigap plans only help to cover out-of-pocket costs in Original Medicare like deductibles, coinsurance, and copays. This means that purchasing a Medigap plan will not get you dental coverage.

Does Medicare Part D cover dental?

Medicare Part D benefits cover prescription drugs, so dental care is not included in Medicare Part D. If you want coverage for dental services, you can consider a Medicare Advantage plan or opt for a stand-alone dental plan from private providers.

Does Medicare cover dental implants?

Original Medicare beneficiaries cannot claim reimbursement for dental implants because they are not deemed medically necessary. Dental implants are used as tooth replacements for people who have lost teeth and are typically more permanent solutions compared to dentures.

However, dental implants will not be covered under Original Medicare, so beneficiaries who require this type of treatment can either opt for a Medicare Advantage plan or a stand-alone dental insurance plan.

Verify with your provider whether dental implants are included in your Medicare Advantage plan and the applicable limits.

Does Medicare cover dental surgery?

Original Medicare may cover dental surgery if it is part of treatment for a covered illness. Dental surgery will be covered under Part A benefits if it is an in-patient procedure or under Part B if it is an outpatient procedure.

Your physician must have deemed the surgical procedure medically necessary for it to be covered by Medicare. Some instances where dental surgery is covered by Original Medicare include:

·         Dental surgery before organ transplant to reduce the risk of infection;

·         Dental surgery following traumatic injury to the jaw;

·         Dental surgery as part of treatment for oral cancer or a tumor;

Does Medicare cover dental crowns?

Crowns are used to restore, protect, or cover damaged teeth, but this procedure is not deemed medically necessary under Medicare, so it will not be covered by your Original Medicare benefits. Dental crowns may be covered by certain Medicare Advantage plans, but this will depend on the provider and plan type you choose.

Does Medicare cover dental infections?

Original Medicare will only cover treatment for dental infections if it is deemed medically necessary for the treatment of a medical condition. For instance, if you need radiation treatment, your physician may deem it necessary to treat an oral infection to reduce the risk of side effects.

Some Medicare Advantage plans include coverage for dental services and may cover dental infections, though.

Does Medicare cover dental cleaning?

Original Medicare does not cover dental cleaning or any other routine dental procedures. However, if you have a Medicare Advantage plan, you may be covered for routine services like teeth cleaning, extractions, and retainers. Check with your Plan C provider to find out if your plan covers dental cleaning.

Does Medicare cover dental extractions?

Original Medicare does not cover dental extractions unless they are deemed medically necessary as part of treatment for a covered medical condition. For instance, if you have a traumatic injury to the jaw, extraction may be covered if your doctor deems it a necessary part of your treatment.

Medicare Advantage plans with dental coverage may cover dental extractions, but this will depend on the provider and plan type.

Does Medicare cover dental bridges?

Dental bridges are not covered under Original Medicare. Some Medicare Advantage plans may cover this type of treatment.

Does Medicare cover dental bone grafts

Medicare does not cover dental bone grafts since Original Medicare only covers dental services that are part of treatment for a covered medical condition. If you have Medicare Advantage, your dental benefits may include coverage for dental bone grafts.

The best way to determine if your current Medicare Advantage or Medicare Part C plan covers dental benefits is to contact your plan directly and ask. However, if you are looking for a Medicare Advantage plan (Part C plan) that may help pay for these benefits, you can use an online Medicare plan finder such as Hella Health. This type of portal allows you to browse for plans that meet your needs without having to give your phone number to have someone call you; you can search for yourself, including screening for those that include Medicare Extra Benefits such as dental. 

Article updated on February 12, 2024.