Dental care is essential to overall health, yet Original Medicare provides almost no coverage for routine dental services. Here's what Medicare members need to know about their options for dental coverage.
Oral health becomes increasingly important as we age. Gum disease, tooth loss, and other dental problems are more common among older adults—and poor oral health has been linked to increased risk for heart disease, stroke, and cognitive decline. Yet nearly half of Medicare beneficiaries don't visit the dentist regularly, often because of confusion about coverage or concern about costs.
If you're on Medicare and wondering whether your plan covers dental care, you're not alone. This guide explains what Original Medicare covers (and doesn't cover), how Medicare Advantage plans fill the gap, and what other options are available.
Medicare is the federal health insurance program for people age 65 and older, certain younger people with disabilities, and people with End-Stage Renal Disease. Most beneficiaries enroll in Original Medicare (Parts A and B), which covers hospital and medical services. Others choose Medicare Advantage (Part C), which provides all Original Medicare benefits plus additional coverage through private insurers.
The key point: Original Medicare does not cover routine dental care. Dental services have historically been excluded from Medicare's definition of essential health benefits, leaving millions of seniors to pay out of pocket for cleanings, fillings, and dentures. In fact, about 70% of dental spending by Medicare beneficiaries comes directly from their own pockets.
Coverage Type | Routine Dental | Medically Necessary Dental | Notes |
Medicare Part A | Not covered | Limited (pre-transplant, jaw surgery) | No monthly premium for most |
Medicare Part B | Not covered | Limited (cancer treatment, ESRD) | New 2025: Dialysis patients covered |
Medicare Advantage | 98% of plans offer dental | Same as Original Medicare | Coverage varies by plan |
Medigap | Not covered | Not covered | Some insurers offer dental riders |
Medicare Part A (hospital insurance) does not cover routine dental procedures—even if those procedures are performed in a hospital. However, Part A may provide limited dental coverage in rare circumstances when dental care is medically necessary as part of another covered treatment:
Oral examinations before kidney transplant, heart valve replacement, or valvuloplasty procedures
Jaw reconstruction surgery after an accident or injury
Dental work is required before radiation treatment for cancer
Extraction of teeth in the jawbone before radiation therapy
While Part A's lack of routine dental coverage may be disappointing, the good news is that most beneficiaries pay no monthly premium for Part A (if they or a spouse worked and paid Medicare taxes for at least 40 quarters).
Medicare Part B (medical insurance) also does not cover routine dental care, including cleanings, fillings, extractions, or dentures. However, the Centers for Medicare & Medicaid Services (CMS) has gradually expanded the definition of medically necessary dental services covered under Part B.
New for 2025: Starting in 2025, Medicare covers dental examinations and treatment for individuals undergoing dialysis for End-Stage Renal Disease (ESRD). This expansion ensures that ESRD patients have equal access to essential dental care, whether they choose dialysis or a kidney transplant.
Part B may also cover dental services when they are "inextricably linked to, and substantially related and integral to the clinical success of" another covered medical service. Examples include dental work before specific cancer treatments or organ transplants.
If dental coverage is a priority, Medicare Advantage (Part C) is likely your best option. Private insurance companies approved by Medicare offer these plans and provide all the benefits of Original Medicare plus additional coverage.
In 2026, 98% of Medicare Advantage plans offer some dental coverage, similar to 2025. However, the type and extent of coverage vary significantly across plans.
Preventive dental coverage may include:
Routine oral exams (typically 1-2 per year)
Cleanings (prophylaxis)
X-rays
Fluoride treatments
Comprehensive dental coverage may also include:
Fillings and extractions
Root canals (endodontics)
Crowns and bridges
Dentures and partial dentures (prosthodontics)
Periodontal (gum disease) treatment
Not all Medicare Advantage dental benefits are created equal. Before enrolling, consider these factors:
Annual maximum: Most plans cap the amount they'll pay for dental care each year, typically between $1,000 and $3,000. If you need extensive work, you may exceed this limit.
Preventive vs. comprehensive: Some plans only cover preventive services (cleanings, exams). Others include major services like crowns and dentures. Check which services are covered before you need them.
Network restrictions: Many plans require you to use in-network dentists. The dental network may differ from the medical network—verify that your preferred dentist accepts the plan's dental benefit.
Cost-sharing: Even with dental coverage, you may owe copays or coinsurance for services. Some 2026 plans are adding coinsurance to non-preventive services.
Waiting periods: Some plans impose waiting periods before major services are covered. If you need a crown in January, make sure the plan covers it immediately.
Exclusions: Read the Evidence of Coverage carefully. Some plans exclude implants, orthodontics, or cosmetic procedures entirely.
Pro tip: Many Medicare Advantage plans offer $0 premiums (beyond your Part B premium) while still including dental benefits. Two-thirds of Medicare Advantage plans with drug coverage charge no additional monthly premium in 2026.
Private insurance companies sell Medigap policies to help cover costs that Original Medicare doesn't pay, such as deductibles, copays, and coinsurance. To be eligible, you must be enrolled in Original Medicare (Parts A and B).
Important: Standard Medigap policies do not cover dental services. Medigap only pays for benefits that are part of Original Medicare—and since Original Medicare excludes routine dental, so does Medigap.
However, some insurance companies offer Medigap policies with optional dental riders or bundle Medigap with a separate dental plan. These add-ons typically increase your monthly premium.
Also note: You cannot have both Medigap and Medicare Advantage. If you're enrolled in a Medigap policy and switch to Medicare Advantage for dental coverage, you'll need to drop your Medigap plan. If you later switch back to Original Medicare, you may be subject to medical underwriting when purchasing a new Medigap policy.
PACE is a Medicare and Medicaid program designed to help seniors who need nursing home–level care remain living at home. If you qualify for PACE, you receive comprehensive coverage including medical care, prescription drugs, and dental services—all coordinated through a PACE center.
Eligibility requirements for PACE include:
Age 55 or older
Live in a PACE service area
Certified by your state as needing nursing home–level care
Able to live safely in the community with PACE services
If you qualify for Medicaid, you may pay little or nothing for PACE. Monthly premiums vary by state and financial circumstances. Once enrolled in PACE, you are no longer eligible for Medigap.
Standalone dental insurance: If you prefer to stay with Original Medicare and Medigap, you can purchase a separate dental insurance plan from a private insurer. Dental HMO plans typically have lower premiums but require you to use in-network dentists. Dental PPO plans offer more flexibility but cost more. Standalone plans often have higher annual maximums than Medicare Advantage dental benefits.
Dental discount plans: These are not insurance but membership programs that provide discounted rates at participating dentists. You pay an annual fee and receive a percentage off dental services.
Medicaid dental coverage: If you qualify for both Medicare and Medicaid (dual eligibility), Medicaid may provide dental coverage depending on your state. Comprehensive dental benefits are available through Medicaid in only 28 states, and coverage varies widely.
Community health centers: Federally Qualified Health Centers (FQHCs) often provide dental services on a sliding-fee scale based on income. These can be a good option for seniors with limited budgets.
For most seniors, Medicare Advantage offers the best combination of dental benefits and affordability. Unlike Original Medicare, these plans typically include preventive dental services at no additional cost, and many cover major procedures as well.
That said, the "best" plan depends on your individual needs:
If you only need routine cleanings and exams: many $0-premium Medicare Advantage plans cover preventive dental at no cost to you.
If you need crowns, dentures, or major work: Look for plans with comprehensive dental coverage and higher annual maximums. Be prepared to pay a higher premium for more extensive coverage.
If you want maximum flexibility: Consider Original Medicare plus a standalone dental plan. This lets you see any dentist and may offer higher coverage limits.
A licensed insurance agent can help you compare Medicare Advantage plans in your area and find one that matches your dental needs and budget.
Why doesn't Original Medicare cover dental?
When Medicare was created in 1965, dental care was not considered essential health care. Despite decades of advocacy and growing evidence linking oral health to overall health, routine dental services remain excluded from Original Medicare's statutory coverage. Bills to add dental coverage to Medicare have been introduced in Congress but have not passed.
Does Medicare Part B cover dental extractions?
No, Part B does not cover routine extractions. However, extractions may be covered when medically necessary as part of another covered treatment—for example, before radiation therapy for cancer or before an organ transplant.
Does Medicare cover dental implants?
Original Medicare does not cover dental implants. Some Medicare Advantage plans may offer partial coverage for implants, but many exclude them. If implants are a priority, check the plan's Evidence of Coverage before enrolling.
Does Medicare cover dentures?
Original Medicare does not cover dentures. Many Medicare Advantage plans with comprehensive dental coverage do include partial or full dentures, though you may owe cost-sharing, and the benefit may be subject to an annual maximum.
Navigating Medicare's dental options can be confusing. At Health Plans of NC, our licensed agents can help you find a plan that offers quality dental coverage at an affordable price—whether that's a Medicare Advantage plan with dental benefits or a standalone dental plan to supplement your Original Medicare coverage.
For more information, call us at 800-797-0327. We look forward to helping you protect your oral health and your budget.