Original Medicare does not cover routine dental care

Original Medicare — the federal program that covers hospital and doctor visits — does not pay for cleanings, fillings, root canals, dentures, or most other dental work. This is true whether you have Medicare Part A and Part B or you have been on the program for decades. The gap exists because dental care was excluded from Medicare when the program began in 1965, and Congress has not changed that rule.

You will pay the full cost of routine dental visits out of your own pocket. Some seniors have dental coverage through a former employer's retiree plan, a union, or a state Medicaid program — those sources may help — but Original Medicare itself does not.

Key Takeaways

  • Original Medicare does not cover cleanings, fillings, dentures, root canals, or most other dental work.
  • Medicare Advantage plans (Part C) sometimes include dental benefits, but coverage varies widely by plan and by region.
  • Medicaid covers dental care in some states for seniors who may have access to by income, but the scope of coverage differs from state to state.
  • Standalone dental discount plans and community health centers offer lower-cost alternatives if you have no dental coverage.
  • You can contact your state health insurance counselor for free help understanding what dental options exist where you live.

Medicare Advantage plans may include dental coverage

Medicare Advantage (also called Part C) is an alternative way to get Medicare benefits through a private insurance company. Unlike Original Medicare, many Medicare Advantage plans do include dental benefits — but not all of them, and the coverage is not the same from plan to plan.

Some plans cover only cleanings and X-rays. Others add fillings and extractions. A few cover more expensive work like crowns or root canals, though usually with a yearly limit on what they will pay. You need to read the plan's summary of benefits for the specific year you are considering, because what one plan covers in your county may differ from what the same company covers in the next county over.

If you are already in a Medicare Advantage plan, you can switch to a different plan during the annual enrollment period (October 15 to December 7 each year) if your current plan's dental benefits do not meet your needs. If you are not yet in Medicare Advantage and dental coverage matters to you, ask the plan directly what it covers before you enroll.

Medicaid covers dental care in some states

Medicaid is a joint federal and state program for people with low income. Some states cover dental care for seniors on Medicaid; others do not. The states that do cover it often limit it to emergency care (pain relief and extractions) rather than preventive or restorative work.

To find out whether your state covers dental care through Medicaid and what the income limits are, contact your state Medicaid office. You can find the phone number by searching "[your state] Medicaid" online or by calling 211, which connects you to local health and human services programs. If you think you might may have access to by income, ask whether you can explore.

Standalone dental plans and discount programs

If you have no dental coverage through Medicare Advantage or Medicaid, you can buy a standalone dental insurance plan or join a dental discount program. These are not insurance — they are membership plans that give you a discount (usually 10 to 60 percent) when you visit a dentist in their network.

Dental discount plans typically cost $80 to $200 per year and have no waiting period, so you can use them right away. Standalone dental insurance plans usually cost more per month but may cover a larger share of the cost after you meet a deductible. Both have limits on what they will pay in a year, and both exclude certain procedures.

Before you buy either type of plan, check whether the dentists you want to see are in the network. A plan that does not include your dentist is not useful to you, no matter how cheap it is.

Community health centers and low-cost clinics

Federally may have access to health centers (FQHCs) are nonprofit clinics that provide dental care on a sliding fee scale based on your income. If you have little or no income, you may pay very little or nothing. If you earn more, you pay a percentage of the cost.

To find a health center near you, search the Health Resources and Services Administration (HRSA) Find a Health Center tool online, or call 211 and ask for dental clinics in your area. Some dental schools also offer low-cost care performed by students under supervision. Call your nearest dental school to ask whether they have a clinic open to the public.

Dental work that Medicare Part B sometimes covers

Original Medicare Part B covers a small number of dental procedures, but only when they are medically necessary — not for routine care. Part B covers dental work needed before radiation or chemotherapy for cancer, or work needed as part of a covered hospital stay.

Part B also covers some oral surgery performed by a hospital dentist or oral surgeon if the procedure is done in a hospital outpatient setting and is medically necessary. This is rare, and you will need a doctor's order. If you think a dental procedure you need might fall into this category, ask your doctor and your dentist to contact Medicare to ask whether it qualifies.

How to find out what dental options you have

Your first step is to know what coverage you currently have. If you are in Original Medicare, you have no dental coverage through Medicare itself. If you are in a Medicare Advantage plan, log into your plan's website or call the member services number on your insurance card to ask what dental benefits are included.

If you want to know what other options exist in your area — Medicaid, community health centers, discount plans — contact your State Health Insurance information Program (SHIP). SHIP counselors are free, trained to answer questions about Medicare, and they know the local resources. You can find your state's SHIP by searching "[your state] SHIP" online or by calling 1-800-MEDICARE.

Frequently Asked Questions

Does Medicare cover dentures?

No, Original Medicare does not cover dentures. Some Medicare Advantage plans include coverage for dentures, but you need to check your specific plan's benefits. If you are on Medicaid in a state that covers dental care, dentures may be covered, but limits vary by state.

Can I get dental coverage if I switch to Medicare Advantage?

Many Medicare Advantage plans include dental benefits, but not all. You can review the dental benefits in each plan available in your area during the annual enrollment period (October 15 to December 7) before you enroll. Call the plan or read its summary of benefits to see exactly what is covered.

What if I need emergency dental care and have no coverage?

Community health centers and dental schools offer low-cost emergency care. Call 211 or search the HRSA Find a Health Center tool to locate a clinic near you. Hospital emergency rooms can treat severe infections or trauma, though they typically extract teeth rather than repair them.

How much does a standalone dental plan cost?

Dental discount plans typically cost $80 to $200 per year and offer discounts of 10 to 60 percent at network dentists. Standalone dental insurance plans cost more but may cover a larger percentage of costs after you meet a deductible. Costs vary by plan and region, so compare options in your area.

Will my state Medicaid cover my dental work?

It depends on your state. Some states cover preventive and restorative dental care; others cover only emergency care; some cover nothing. Contact your state Medicaid office or call 211 to find out what your state covers and whether you meet the income limits to explore.