Medicare is a vital health insurance program for older Americans, covering a broad range of services that support healthy aging and independence. But while original Medicare (Parts A and B) includes many preventive benefits, you may be surprised to learn that its coverage of dental care is limited. 

In this guide, you’ll find out what types of dental services are excluded from traditional Medicare, which ones are covered, and how to expand your dental coverage to get the oral care you need.

Does Medicare pay cover routine teeth cleaning?

No, original Medicare (Part A and Part B) does not cover routine oral health and dental care, such as teeth cleaning, fillings, dentures, and root canals. If you are enrolled in a private Medicare Advantage (Part C) plan, check to see if your plan covers these services.

When does Medicare cover dental treatment?

Medicare has specific guidelines when it comes to dental services. While routine dental care is typically not covered under original Medicare (Parts A and B), there are certain situations in which Medicare may provide coverage for dental services. It’s important to understand these guidelines to ensure you have the coverage you need for your oral health.

Below is an overview of what dental services are covered under Medicare’s different parts.

• Part A: Hospital Insurance. Part A may cover dental procedures if they are part of a hospital stay. For instance, if you are hospitalized for surgery or a medical condition that requires dental treatment as part of your care plan, Medicare may cover these services. This coverage is specific to dental care that is deemed medically necessary during a hospitalization.
• Part B: Medical Insurance. Part B may provide coverage for dental services that are necessary for other outpatient medical procedures. For example, Medicare may cover the costs of dental services associated with these procedures: Organ transplant, heart valve replacement, jaw surgery, and valvuloplasty. Medicare may also cover certain oral health services if they’re related to treatment for head or neck cancer. However, it won’t pay for any follow-up dental care once the main medical condition has been addressed.
• Part C: Medicare Advantage. Medicare Advantage plans, sold by private insurance companies, combine the coverages of original Medicare with additional benefits. These extra benefits often include coverage for routine dental services. Medicare Advantage plans may cover services such as annual cleanings, exams, X-rays, and even more complex procedures like fillings and crowns. Since coverage varies by plan, it’s important to review the details of each specific Medicare Advantage plan to ensure it meets your dental care needs.

Where can I get help paying for dental work?

If you're having trouble affording dental care services, check with one of the following resources to see if they can help:

• The Dental Lifeline Network of the American Dental Association runs a program offering free, comprehensive dental treatment for older adults and people living with disabilities.
• Community Health Centers (CHCs) supported by the Health Resources and Services Administration provide health services, including dental care, to people with limited incomes. Fees are typically set based on a sliding scale.
• Dental schools often offer low-cost cleaning and care to give dentists-in-training an opportunity to practice their skills. Check with the American Dental Association to find a program in your area.
• Dentistry from the Heart hosts community events with local dentists who offer one free cleaning, extraction, or filling.

Need help navigating your Medicare options?

Will Medicare Parts A and B provide enough coverage for your health care needs? Can you afford the out-of-pocket costs?

If you’re feeling confused by your Medicare choices and you’d like some sound advice, reach out to your State Health Insurance Assistance Program (SHIP). Your SHIP will connect you with a counselor who will provide free, practical guidance on choosing the right plan based on your personal health situation and budget. Ready to get started? Find your SHIP today.