If you’re struggling to understand Medicare, Connie can help. Ask Connie your question and a local, licensed agent will help you navigate your Medicare journey. Complete this form to have your question answered. It could be featured on Dear Connie.
Dear Connie,
I’ve signed up for Medicare Part A and B but heard from friends that Medicare doesn’t cover dental. That worries me because I’m having a hard time paying for healthcare as it is. I don’t think I’ll be able to afford to pay for dental if it’s not included. I’m wondering, does Medicare cover dental?
I’m so happy you’ve asked this common and essential question. Being proactive about your dental health is vital to your overall health.
Poor oral health has been linked to Endocarditis, an infection of the inner lining of your heart or valves (endocardium); Cardiovascular Disease related to inflammation and infections that oral bacteria can cause; plus Pneumonia and other respiratory diseases caused by bacteria in your mouth being pulled into your lungs.
Some conditions can also cause poor oral health and lead to the diseases mentioned. Suppose you have Diabetes, HIV/AIDS, Osteoporosis, Alzheimer’s Disease, an eating disorder, Rheumatoid Arthritis, Cancer, or Sjogren’s Syndrome. In that case, you’ll want to stay on top of your oral health to guard against worsening conditions.
As a preventative measure, going to the dentist can also detect Ulcerative Colitis or Crohn’s Disease, HIV/AIDS, Diabetes, and Leukemia.
And although we know that our dental health is linked to overall health, Original Medicare doesn’t cover most routine dental care.
“Original Medicare and Medigap plans do not provide comprehensive routine dental coverage. Medicare Advantage plans are the only Medicare plans that do. “
If you’re looking for routine dental care, Original Medicare Part A and B or a Medicare Supplement (Medigap) plan won’t help. If you currently have Original Medicare, you’re likely one of the nearly half (47%) of Medicare beneficiaries who do not have dental coverage.
For those who received some dental services, the average out-of-pocket spending was $874, and 20% of people spent more than $1,000 out-of-pocket on dental care. That’s a lot for a limited income!
It sounds like you’re worried about dental care and are trying to reduce out-of-pocket costs. You have a few options:
A Medicare Advantage plan that includes coverage for dental
A stand-alone dental insurance plan
A dental discount plan that isn’t health insurance but provides a discount on services, including cleanings and fillings.
The only Medicare plan that offers dental coverage is the Medicare Advantage plan. Medicare Advantage plans are offered by private insurance companies, regulated by the Centers for Medicare and Medicaid Services (CMS), and cover a variety of dental procedures. Medicare Advantage plans start at a $0 monthly premium and often include dental, vision, and hearing benefits. While you only asked about dental, a Medicare Advantage plan could help reduce out-of-pocket vision and hearing costs.
If you want to keep your Original Medicare, you may be interested in a stand-alone dental insurance plan. However, you’ll need to keep in mind that these plans include a monthly premium and coinsurance for services.
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Some stand-alone dental plans also have a 12-month waiting period. Exceptions can be made if you show proof of dental coverage for the previous 12 months. But, in general, you should expect a wait for services like bridges, crowns, dentures, root canals, and oral surgery, among others.
Alternatively, your Original Medicare paired with a dental discount plan could help reduce the cost of dental services. You often receive discounts on routine and major dental procedures for a fixed monthly member rate.
A Medicare Advantage plan can offer you dental, vision, and hearing coverage, while a stand-alone dental insurance or discount plan covers only dental. All three are good options, and we can help you weigh which is right for your health needs and budget.
At Connie Health, we help you throughout your Medicare journey. If you’d like to review Medicare Advantage plans that offer dental in your area, you can call (623) 223-8884 or use our online Medicare plan comparison tool.
If you ever wonder if another service or test is covered, contact a local licensed Connie Health agent at (623) 223-8884 for help.
Medicare Advantage plans that offer dental plan benefits cover the cost of routine dental care such as cleanings, fillings, dentures, and tooth extractions. Let your local licensed Connie Health agent know if you want dental implants. They can provide plan options that include this benefit.
If you’re enrolled in a Medicare Advantage plan, review the Evidence of Coverage (EOC) document associated with the plan. You’ll need to search for “dental implants” or “prosthodontics” in the EOC and carefully examine the products and services covered. If you discover that your plan doesn’t cover dental implants, you may be able to make a plan change, and a Connie Health agent can help.
What dental services are covered by Medicare?
Original Medicare does not cover preventative or routine dental care. However, Medicare Part A or B will pay for dental services you receive while in the hospital, including emergency and related medical procedures (cardiac or organ transplant procedures).
In 2023 and 2024, Original Medicare expanded its dental services coverage to include dental or oral exams before:
Organ transplant surgery,
Cardiac valve replacement or valvuloplasty procedures,
Head and neck cancer treatment,
Chemotherapy,
Chimeric antigen receptor (CAR) T-cell therapy,
Administration of high-dose bone-modifying agents when used in the treatment of cancer.
Medicare will also cover dental treatment to address complications after radiation, chemotherapy, and/or surgery from head and neck cancer. In addition to these changes, Medicare has expanded its rule on medically necessary dental services that Original Medicare covers. Now, if dental and medical professionals coordinate care, Original Medicare may pay for the services and critically necessary ancillary services like X-rays, administration of anesthesia, or the use of an operating room.
The only Medicare plan that offers routine dental coverage is the Medicare Advantage plan. These plans start at a $0 monthly premium and often include dental, vision, and hearing benefits. Let your local licensed Connie Health agent know if you’d like routine dental covered. They can help you find the best option for you, in your area.
Does Medicare cover dental crowns?
Original Medicare (Part A and B) does not cover dental crowns or routine dental care.
The only Medicare plan that offers dental crowns is the Medicare Advantage plan. Medicare Advantage plans start at a $0 monthly premium, often including dental, vision, and hearing benefits. Let your local licensed Connie Health agent know if you’d like to find a plan that includes dental crowns. They can search for and provide plan options that include this benefit.
If you’re enrolled in a Medicare Advantage plan, review your Evidence of Coverage to learn if dental crowns are covered. You may need to search for “dental crowns” or call and speak with your plan. If you discover that your current plan doesn’t cover dental crowns, you may be able to make a plan change, and a Connie Health agent can help you weigh your options.
Does Medicare Advantage cover dental?
At a minimum, Medicare Advantage plans must cover what Original Medicare Part A and B cover. However, many Medicare Advantage plans offer more benefits than Original Medicare, including routine dental coverage. If you want a particular dental service or procedure covered, communicate that to your local licensed Connie Health agent. They can share plans that include these benefits.
If enrolled in a Medicare Advantage plan, you can review the Evidence of Coverage (EOC) or speak with your plan to learn if that procedure or service is covered.
Does Medicare cover dental extractions?
Original Medicare does not cover dental extractions unless they are medically necessary and completed with coordinated care from a dental and medical professional. Dental extractions are not covered under Original Medicare as routine care. Instead, tooth extractions would be dental care you receive while in the hospital, including emergency and related medical procedures.
If you want your Medicare plan to include dental extractions, you will need to enroll in a Medicare Advantage plan. Medicare Advantage plans cover everything that Original Medicare Part A and B cover, with extra benefits like routine dental coverage. If you want dental extractions covered, let your local licensed Connie Health agent know. They can share plans that include this benefit.
If enrolled in a Medicare Advantage plan, review the Evidence of Coverage (EOC) or speak with your plan to learn if extractions are covered. If they aren’t, Connie Health can help you find and change to a plan that does.
I am a Spanish-speaking Texas Life and Health Insurance Licensed Agent and have been helping people with Medicare since 2007. I am on the the Advisory Committee for Foster Grandparents, Senior Companions, and RSVP Houston. I enjoy traveling, a backyard BBQ, and volunteering in my community.
(623) 223-8884 | TTY: 711
(623) 223-8884 | TTY: 711
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Compare all major plans and carriers
Local, licensed insurance agents with 25+ years of experience
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