Original Medicare specifically excludes most dental work, such as cleanings, fillings and dentures. There are exceptions, and Medicare Part A covers dental services that you receive in the hospital related to another illness. Medicare also may cover basic hospital care if you're admitted as an inpatient because of a dental emergency. In addition, some Medicare Advantage plans offer more dental coverage than original Medicare.
Excluded Dental Care
Ordinary dental procedures such as check-ups, fillings, crowns, root canals and extractions aren't covered by original Medicare. Medicare never pays for bridges or dentures, even if you had teeth pulled as part of a procedure Medicare paid for. In addition, original Medicare won't pay to treat periodontal problems, such as infected gums or bone loss.
Covered Dental Services
Medicare pays for dental services that you must have to receive another covered procedure. For example, if you need jaw reconstruction after an accident, Medicare pays for any dental services related to the reconstructive surgery. If you have teeth pulled in preparation for some other treatment -- such as a treatment for cancer -- Medicare pays for the extractions, but not for the replacement teeth or dentures.
Dental exams are covered only in special circumstances for serious illnesses. If you need a dental check-up in preparation for a kidney transplant or heart valve replacement, the exam is covered. Nonetheless, if the exam reveals that you need dental work, Medicare doesn't cover that additional work.
Medicare also covers hospital costs such as x-rays, anesthesia and room charges when you're hospitalized because of a serious dental problem, such as an infection. The fees for the physicians and dentists aren't covered.
Advantage Plans, Supplements and Medicaid
All Medicare Advantage plans offer at least as much dental coverage as original Medicare. In addition, many Advantage plans offer coverage of routine dental procedures, such as exams and cleanings.
Some insurance companies offer supplemental dental insurance for Medicare subscribers. Depending on the particular policy, a dental supplement may cover check-ups, cleaning, fillings and x-rays, with partial coverage of root canals, extractions and dentures.
If you also qualify for Medicaid, you may receive emergency dental care through that program. In addition, some state programs include comprehensive dental coverage. Federal law allows each state to decide how much dental coverage to offer adults through Medicaid.
- Medicare.gov: Your Medicare Coverage: Dental Services
- Center for Medicare & Medicaid Services: Medicare Dental Coverage
- Medicare Interactive: Does Medicare Ever Cover Dental Services?
- Medicare.gov: What's Not Covered by Part A & Part B
- Medicare.gov: Medicare Advantage Plans Cover All Medicare Services
- Washington State: Office of the Insurance Commissioner -- Dental
- Humana.com: 2015 Optional Supplemental Benefits
- Medicaid.gov: Dental Care
- Medicare.gov: Sign Up/Change Plans
- Medicare.gov: Medicare Plan Finder
- Medicaid.gov: How Do I Apply for Coverage?
- Center for Medicare & Medicaid Services: Dual Eligible Beneficiaries Under the Medicare and Medicaid Programs