Does Medicare cover dental services?

Original Medicare (Part A for hospital coverage and Part B for medical coverage) typically does not include routine dental coverage, such as dental exams, cleanings, fillings, crowns, and bridges. There are, however, some exceptions to this rule.

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If you want to be able to combine coverage for routine dental care with other medical and hospital coverage, you can get that with a Medicare Advantage plan (Part C). If you want to keep Original Medicare, consider adding a Medigap plan with dental benefits or a separate dental plan. Click here to see more information regarding Medigap.

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Since routine dental coverage is not available under Original Medicare, you are generally responsible for the full cost of your dental care unless you have other dental insurance.

Original Medicare and Medigap don’t cover dentures. If you know you may need dentures, you may want to enroll in a Medicare Advantage plan or separate dental plan that specifically offers denture coverage.

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Part C- Dental coverage through Medicare Advantage plan

You may be able to get dental coverage under some Medicare Advantage plans. Medicare Advantage plans (Part C) can include extra benefits like routine dental, routine vision, and Medicare prescription drug coverage. At Dr. Roger Ho's dental care, We do accept Medicare Advantage PPO dental plans.

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Medicare Advantage covered services could include:

• Oral exams

• Cleanings ((2~3 times a year)

• Dental X-rays

• Diagnostic services

• Restorative services including fillings

• Endodontics (root canal treatment)

• Periodontics (treatment of gum disease and oral inflammation)

• Extractions

• Prosthodontics (crowns, bridges, implants, and dentures)

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You generally will pay a copayment or coinsurance for most Medicare Advantage dental coverage, such as 20% coinsurance for fillings. 

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Part A, Part B- Original Medicare

As mentioned, unless you enroll in a Medicare Advantage plan that includes routine dental coverage, you’ll typically have to pay the full cost for routine dental care. However, there are other ways to cover dental costs outside of what’s covered by Medicare, including dental insurance and dental discount cards. Please note that these types of dental coverage are not part of Medicare.

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An example:  

If you suffer an accident that results in damage to the jaw, Medicare would cover the medical reconstruction of the jaw. Or if you have a disease involving the jaw, Original Medicare might cover a tooth extraction that is directly caused by the disease.

For emergency and complicated dental procedures that require a hospital stay, Medicare Part A covers the hospital stay but not the dental procedure.

If you’re having a kidney or heart transplant or another complicated procedure that requires a preliminary dental exam, Medicare covers the dental exam either under Medicare Part A or Medicare Part B, depending on whether the dental exam is performed by hospital staff or an in-office physician.