Does Medicare Cover Dental Care? Check the Type of Coverage

Original Medicare usually does not pay for routine dental care. Some Medicare Advantage plans offer a separate dental benefit, with their own rules. Having Medicare does not establish that a cleaning, crown or other proposed procedure will be paid.

Start with the insurance card

A medical exception is not a general dental benefit

Medicare can cover certain dental services closely connected to specific covered medical care. Your treating professionals must establish that connection and the applicable criteria. Being in a hospital, having an infection or receiving a dentist's recommendation does not by itself guarantee payment.

Before you approve an estimate

• Ask the dentist for procedure codes and a written cost estimate.
• Confirm the dentist's participation in your particular dental network.
• Ask whether prior authorization or a pretreatment estimate is required.
• Separate the plan's estimated payment from your expected responsibility.
• Check whether the annual benefit has already been partly used.

Understand the estimate's limits

A predetermination helps you plan, but eligibility, remaining benefits and the services actually performed can affect the final claim. Save the estimate and the plan's written response. Ask who will contact you if the treatment plan changes before additional work is performed.

Medigap pays specified Original Medicare cost sharing; it does not turn routine dental care into a covered Medicare benefit. If you also have Medicaid, check the state's dental program separately. Your dentist decides clinical care; the insurer explains coverage.

Continue with a related question

• Dental Implants and Medicare: Verify Coverage Before Treatment
• Dental Bridges and Medicare: Coverage Questions
• Medicare and Medicaid: Different Programs, Coordinated Help

Official information

• Medicare.gov — Dental services
• Medicare.gov — Your Medicare Benefits