Coverage
Does Medicare Cover Dental?
Generally, Original Medicare does not cover dental services including cleanings, fillings, bridges, dentures, routine exams and teeth extractions.
However, if you have a dental emergency that requires immediate care in a hospital, Part A of your Medicare coverage will typically pay for your care.
If you want dental coverage, you can buy a private dental insurance plan, or you can enroll in a Medicare Advantage plan that includes dental coverage.
When Does Medicare Cover Dental Services?
While Medicare does not cover routine dental services, Part A may provide some coverage in emergency situations.
Some situations in which Medicare may cover dental services are listed below.
- You need surgery to correct fractures of the jaw
- You need dental splints as a result of jaw surgery
- You need tooth extractions in preparation of radiation treatment for neoplastic diseases
- You receive a dental exam in a hospital before a heart valve replacement or kidney transplant
- You have oral cancer or another disease that affects the jaw and require dental services for treatment
Keep in mind that every situation is unique and you should speak with your doctor to find out if a specific dental service will be covered by Medicare.
Your Medicare Out-of-Pocket Costs
Even if your dental procedure is covered by Medicare, you may still have to pay some money out of pocket.
Some of your Medicare out-of-pocket costs in 2019 can include:
Medicare Part A deductible
- $1,556 per benefit period in 2022. This is the amount you have to pay in a benefit period before your Medicare Part A benefits kick in and begin paying for your hospital costs.
Medicare Part B deductible
- $233 per year in 2022. You have to pay this amount within the year before Medicare Part B pays for services it covers.
Medicare Part A coinsurance
- $0 coinsurance per day for days 1-60 of an inpatient hospital stay
- $389 coinsurance per day for days 61-90 in 2021
- $778 coinsurance per each lifetime reserve day after day 90 of your hospital stay (you have up to 60 reserve days over your lifetime)
- All costs beyond your lifetime reserve days are all used
Medicare Part B coinsurance
- 20 percent of the Medicare-approved amount for most health services and medical devices
If you have Original Medicare, you may consider purchasing Medicare Supplement Insurance, which can help cover some of these out-of-pocket costs.
Medicare Supplement Insurance
Medicare Supplement Insurance (also known as Medigap) helps cover some of the out-of-pocket costs of Original Medicare.
Medicare Supplement Insurance plans do not cover dental services. However, if you suffer a dental emergency and must visit the hospital, a Medicare Supplement Insurance plan may cover your Medicare Part A deductible and copayment, as well as your Medicare Part B deductible.
The out-of-pocket Medicare costs your Medigap plan would cover depends on which type of plan you buy. Additionally, some Medicare Supplement Insurance plans cover foreign travel emergency care, meaning you can have certain services covered if you experience an emergency outside of the U.S.
There are 10 standardized Medigap plan types in most states, each offering a unique combination of basic benefits. All 10 standardized Medigap plans cover your Medicare Part A coinsurance and hospital costs.
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Medicare Supplement Benefits
Part A coinsurance and hospital coverage
Part B coinsurance or copayment
Part A hospice care coinsurance or copayment
First 3 pints of blood
Skilled nursing facility coinsurance
Part A deductible
Part B deductible
Part B excess charges
Foreign travel emergency
Medicare Supplement Benefits | A | B | C* | D | F1* | G1 | K2 | L3 | M | N4 |
---|---|---|---|---|---|---|---|---|---|---|
Part A coinsurance and hospital coverage | ||||||||||
Part B coinsurance or copayment | 50% | 75% | ||||||||
Part A hospice care coinsurance or copayment | 50% | 75% | ||||||||
First 3 pints of blood | 50% | 75% | ||||||||
Skilled nursing facility coinsurance | 50% | 75% | ||||||||
Part A deductible | 50% | 75% | 50% | |||||||
Part B deductible | ||||||||||
Part B excess charges | ||||||||||
Foreign travel emergency | 80% | 80% | 80% | 80% | 80% | 80% |
* Plan F and Plan C are not available to Medicare beneficiaries who became eligible for Medicare on or after January 1, 2020. If you became eligible for Medicare before 2020, you may still be able to enroll in Plan F or Plan C as long as they are available in your area.
+ Read more1 Plans F and G offer high-deductible plans that each have an annual deductible of $2,490 in 2022. Once the annual deductible is met, the plan pays 100% of covered services for the rest of the year. The high-deductible Plan F is not available to new beneficiaries who became eligible for Medicare on or after January 1, 2020.
2 Plan K has an out-of-pocket yearly limit of $6,620 in 2022. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
3 Plan L has an out-of-pocket yearly limit of $3,310 in 2022. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
4 Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to $50 copayment for emergency room visits that don’t result in an inpatient admission.
- Read lessAlthough a Medicare Supplement Insurance plan will not cover routine dental services, it could save you significant money if you have a dental emergency.
If you make frequent visits to the dentist, you may also consider enrolling in dental insurance policy through a private insurer.
Dental hygiene becomes even more important as you age and poor oral health can increase the risk for things like diabetes and heart disease, so it's critical for all aging adults to maintain regular dental checkups.
Find Medicare Supplement Insurance Plans Where You Live
Call to speak with a licensed insurance agent who can help you find Medicare Supplement plans in your area that can help cover some of your out-of-pocket Medicare costs when you need dental care that Medicare does cover.
Compare Medigap plans in your area.
Find a planOr call 1-800-995-4219 to speak with a licensed insurance agent.