Dental Services Covered by Medicare
Ian C. Langtree - Writer/Editor for Disabled World (DW)
Published: 2009/03/16 - Updated: 2024/08/22
Publication Type: Informative
Category Topic: U.S. Medicare System - Academic Publications
Page Content: Synopsis - Introduction - Main
Synopsis: Explains what medicare will cover in regards to dental work and procedures as part of a condition requiring hospitalization. Medicare generally does not cover dental procedures unless they are done as part of and directly connected with some other Medicare covered condition requiring hospitalization
Introduction
Medicare generally does not cover routine dental services. This includes services such as regular checkups, cleanings, fillings, dentures, and most tooth extractions. However, Medicare does provide limited coverage for dental services that are necessary for certain medical procedures or conditions.
Main Content
Covered Dental Services
Medicare may cover dental services in the following situations:
- Pre-surgical Examinations: Oral examinations are covered if they are necessary before certain surgeries, such as a kidney transplant or heart valve replacement.
- Cancer Treatment: Dental procedures, like tooth extractions, may be covered if they are required before undergoing radiation treatment for jaw-related diseases, such as oral cancer.
- Jaw Surgery: Medicare may cover surgery to treat fractures of the jaw or face, or reconstruction of the jaw following the removal of a facial tumor.
- Hospitalization: If a dental procedure requires hospitalization due to an underlying health condition or the severity of the procedure, Medicare may cover the hospital costs but not the dentist's fees.
Medicare Advantage Plans
Some Medicare Advantage Plans, which are offered by private insurance companies, may include coverage for routine dental services. The extent of this coverage can vary, so it is advisable for individuals to check with their specific plan provider to understand what dental services are included.
Out-of-Pocket Costs
For services not covered by Medicare, individuals are responsible for the full cost unless they have additional dental insurance or access to low-cost dental resources. Medicare Part B may cover some outpatient services related to dental care, but beneficiaries must pay a deductible and coinsurance.
While Original Medicare offers very limited dental coverage, primarily related to specific medical conditions and procedures, some additional coverage may be available through Medicare Advantage Plans.
Author Credentials: Ian is the founder and Editor-in-Chief of Disabled World, a leading resource for news and information on disability issues. With a global perspective shaped by years of travel and lived experience, Ian is a committed proponent of the Social Model of Disability-a transformative framework developed by disabled activists in the 1970s that emphasizes dismantling societal barriers rather than focusing solely on individual impairments. His work reflects a deep commitment to disability rights, accessibility, and social inclusion. To learn more about Ian's background, expertise, and accomplishments, visit his full biography.