If you’ve had employer-sponsored health insurance, it may have included a dental plan that paid for regular cleanings, extractions, and other services that maintain or restore healthy teeth. Dental coverage through Medicare is a bit trickier. Here’s how to know whether you’ll have to pay your dentist out of pocket.
Original Medicare (Parts A and B) doesn’t pay for most dental services (including dentures), unless the service is required before you can receive care that is covered. If you need a tooth extracted before going through radiation, for example, Original Medicare will likely cover it.
Does Medicare cover oral surgery?
If you have Original Medicare, Part A may foot the bill, provided your oral surgery procedure is considered medically necessary. If you have a tumor in your mouth that your doctor says needs to be removed, for example, Part A will likely cover it. But you should always verify with your medical provider before a procedure to avoid surprise Medicare bills.
If you have Medicare Advantage with dental coverage, however, your plan may cover the procedure you want as part of your overall oral health. Most Advantage plans that include dental also cover checkups, cleanings, fillings, and more. If you need dental coverage, check out our guide to Medicare Advantage plans.
Which dental services do Medicare Advantage plans cover?
Private insurers provide Medicare Advantage plans. That means your Medicare costs may vary depending on the plan you choose—and so could your dental coverage. Some plans don’t include dental at all or require you to pay an additional premium to add this coverage. Medicare Advantage plans that do include dental services typically offer either preventative or comprehensive dental.
Preventative dental coverage
This coverage typically includes procedures that help maintain healthy teeth, such as the following:
- Oral exams
- Fluoride treatments
Comprehensive dental coverage
Comprehensive coverage typically includes most dental services, including the following:
- Preventative services
- Periodontal maintenance cleanings
- Root canals
- Tooth extractions
- Dental surgeries
Does Medicare Supplement cover dental care for seniors?
Standardized Medicare Supplement (Medigap) plans do not provide dental coverage for seniors or people with disabilities. Many insurance companies allow beneficiaries to add a dental plan to their Medigap coverage for an additional premium.
To buy Medicare Supplement insurance, you must have Parts A and B. Learn more about the different parts of Medicare with our Medicare guide.
What if I don’t have dental coverage?
If you have Original Medicare and want dental coverage, you can switch to Medicare Advantage during Medicare Open enrollment October 15 through December 7 each year. Or, if your state offers innovative Medigap plans with dental coverage, you could add a Medicare Supplement plan to your current coverage.
If you have a Medicare Advantage plan that doesn’t include dental coverage, you also have options. You can change plans during the fall open enrollment period or use the Medicare Advantage Open Enrollment period (January 1 through March 31). If you’re new to Medicare, learn more about Medicare eligibility.
Finally, if you’re eligible, your state’s Medicaid program may cover your dental services. Make sure you understand the difference between Medicare and Medicaid.
Ready to add Medicare dental coverage?
Whether you’re looking for an innovative Medigap plan or a Medicare Advantage plan, a licensed sales agent can help. Call the number below to find Medicare dental coverage options that work for you.
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