Although Original Medicare covers hospital and doctor visits, it typically won’t cover most dental care. If you need a routine exam, a cleaning, dentures or fillings, you won’t be able to get coverage through Original Medicare. However, there are other parts of Medicare that may offer dental coverage.
Original Medicare doesn’t cover most dental care, dental procedures or supplies, like cleanings, fillings, tooth extractions, dentures, dental plates or other dental devices.1
Although Original Medicare doesn’t cover the type of care you’d get in a dentist’s office, Medicare Part A (hospital insurance) will pay for certain dental services that you get when you’re in a hospital. You may get coverage for some dental treatments that are part of another Medicare-covered service, or dental care designed to protect your overall health. For example, Medicare may help pay for oral exams before a surgery or dental services related to radiation treatment. It may also pay for inpatient hospital care if you need to have emergency or complicated dental procedures, even though the dental care isn’t covered.
But if you simply have a toothache that’s driving you crazy, you’ll have to pay out of pocket to see a dentist. However, you could get dental coverage through some Medicare Advantage plans.
Some Medicare Advantage plans offer extra dental and vision benefits that Original Medicare doesn’t cover.1 Medicare Advantage plans may offer basic coverage for dental services, which can include:
- Preventive dental exams
- Teeth cleanings
- Dental fillings
Usually, these types of Medicare Advantage plans will require you to visit an in-network dentist to be covered. These added dental benefits will vary by plan and most likely require deductibles and copays, so be sure to check out the details before you decide.
If you have Original Medicare, you’ll have to pay out of pocket for most dental services. The costs for common dental procedures may vary based on your dentist or where you live.
No. Medigap or Medicare Supplement Insurance plans are sold by private companies to fill “gaps” in medical insurance that Original Medicare doesn’t cover. Medigap insurance policies may help you pay for things such as copayments or deductibles for medical care. However, these plans do not offer coverage for dental services.
For an added layer of protection, some Medicare Advantage plans may be paired with a dental insurance plan. You'll have to pay a monthly premium and satisfy deductibles and copays, but the cost may be offset by lower out-of-pocket fees. Most of these dental plans require that you see an in-network dentist. Some plans let you go to any dentist (in or out of network), but you may have to pay more for their services.
A dental discount plan may be worth considering if you don’t have dental insurance. These discount plans aren’t dental insurance. They are a type of membership, similar to a warehouse club, but rather than getting bargains on food or clothing, you get discounted prices on dental services.