Poor dental health doesn't just affect your smile — it's linked to heart disease, diabetes, and other serious conditions. Yet Original Medicare leaves dental care largely uncovered, leaving millions of seniors to pay out of pocket for needed dental work.
What Does Original Medicare Cover for Dental?
Very little. Original Medicare Part A and Part B cover dental care only in very limited circumstances:
- Dental care that is integral to a covered medical procedure (such as jaw reconstruction after an accident)
- Dental exams before certain heart or kidney procedures
- Oral cancer screenings in some cases
Routine dental care — cleanings, X-rays, fillings, crowns, root canals, dentures — is not covered by Original Medicare.
How Medicare Advantage Fills the Gap
Most Medicare Advantage plans include dental coverage as an added benefit. Coverage varies by plan but commonly includes:
- Preventive care — routine cleanings (usually 2 per year), X-rays, and exams at no or low cost
- Basic restorative care — fillings, simple extractions
- Major restorative care — crowns, bridges, dentures, root canals (often with a copay or coinsurance)
- Orthodontics — some plans cover adult orthodontics or denture fittings
What to Look for in Dental Coverage
When comparing Medicare Advantage plans for dental benefits, pay attention to:
- Annual benefit maximum — how much the plan covers per year (often $1,000–$3,000)
- What services are covered — preventive only, or comprehensive?
- Network dentists — is your dentist in-network?
- Waiting periods — some plans require a waiting period before covering major work
- Copays and coinsurance — what's your share of the cost?
Can I Get Standalone Dental Coverage?
Yes. If you have Original Medicare and want dental coverage, you can purchase a standalone dental insurance plan. However, these often come with waiting periods, annual maximums, and separate premiums.
Many people find it more cost-effective to switch to a Medicare Advantage plan that bundles dental coverage, especially if the plan has a $0 premium.