Most dentists do not accept Medicare, and Medicare does not cover routine dental care
Medicare Part A and Part B do not pay for cleanings, fillings, crowns, root canals, dentures, or other standard dental work. The only dental services Medicare covers are tooth extractions and other oral surgery that happen in a hospital setting — and only if a medical condition, not decay or gum disease, makes the surgery necessary. If you need a tooth pulled because of an infection that is spreading to your jaw, Medicare may cover it. If you need it pulled because of a cavity, Medicare will not.
Because Medicare does not cover dental care, most dentists have no reason to become a Medicare provider and do not. You will pay the full fee at the dentist's office, the same way you would pay for any service Medicare does not cover. Some dentists may offer a discount to Medicare beneficiaries as a courtesy, but this is not common and is never may provide.
If you need dental work, your options are to pay out of pocket, buy a separate dental insurance plan, or look for a community health center that charges on a sliding scale based on income.
Key Takeaways
- Medicare Part A and Part B do not cover routine dental care such as cleanings, fillings, or crowns under any circumstance.
- The only dental services Medicare covers are tooth extractions and oral surgery performed in a hospital when medically necessary for a condition other than decay or gum disease.
- Most dentists do not accept Medicare because there is nothing for Medicare to pay, so you will be responsible for the full cost of care.
- Community health centers and dental schools often charge less than private practices and may base fees on your income.
- Standalone dental insurance plans and dental discount programs are separate from Medicare and must be purchased on your own.
When Medicare does cover dental work
Medicare covers dental services only when they are performed in a hospital or ambulatory surgical center and are medically necessary — meaning the procedure treats a medical condition, not a dental one. The distinction matters. If you have an infection in your jaw bone that is spreading to other tissues, and a dentist or oral surgeon must extract a tooth to stop it, Medicare may cover the extraction because the underlying problem is medical. If the same tooth is decayed and needs to be pulled for dental reasons, Medicare will not.
You must also meet two conditions: the procedure must be performed by a physician or oral surgeon in a hospital setting, not in a dental office, and your doctor must document that the procedure is medically necessary. Routine dental work performed in a dental office — even if it involves surgery — is never covered.
If you think a dental problem may may have access to for coverage, contact your doctor first, not your dentist. Your doctor can determine whether the condition is medical in nature and whether a hospital-based procedure is necessary.
How to find a dentist and pay for care
Since Medicare does not cover dental work, you have three main paths: pay out of pocket at a private dentist, buy a separate dental plan, or use a community health center.
Private dentists set their own fees and do not negotiate with Medicare. Call ahead and ask the cost of the work you need. Prices vary widely by location and by dentist. A filling might cost $150 to $300 depending on where you live and which dentist you see.
Standalone dental insurance plans are sold by private companies, not by Medicare. These plans have their own premiums, deductibles, and coverage limits. Some plans cover preventive care (cleanings and X-rays) at no cost after you meet a deductible, while others cover a percentage of major work like crowns. Plans sold through the Health Insurance Marketplace may be available in your area. You can also buy dental plans directly from insurance companies. Costs and coverage vary widely, so compare plans before you buy.
Community health centers and federally may have access to health centers (FQHCs) often have dental clinics that charge on a sliding scale based on your income. If your income is very low, you may pay little or nothing. You can find a center near you by searching the HRSA Find a Health Center tool online or by calling 211 and asking for dental services in your area.
Dental discount programs as an alternative
Dental discount programs are membership plans that give you a percentage discount at participating dentists — usually 10 to 60 percent off the regular fee. They are not insurance. You pay an annual membership fee (often $80 to $200 per year) and then pay the discounted price at the dentist's office when you go. The dentist is paid in full by you; the program straightforward negotiates a lower rate.
Discount programs work best if you need a lot of dental work and can find a participating dentist near you. Before you join, check whether the dentists you want to use are in the network. Some programs have large networks; others have very few dentists in rural areas.
Discount programs are not regulated the same way insurance is, so read the terms carefully. Some programs exclude certain procedures or have limits on how much they will discount. Ask the program in writing what is and is not covered before you pay the membership fee.
Dental schools and low-cost clinics
Dental schools train dentists by having students perform procedures under the supervision of licensed instructors. The work is done correctly, but it takes longer than it would at a private practice because the student must explain each step and the instructor must check the work. Fees are typically 30 to 50 percent lower than private dentists charge.
To find a dental school near you, search online for "dental school" or "dental college" in your state plus "clinic" or "patient services". Call and ask whether they accept new patients and what procedures they offer. Some schools focus on general dentistry; others offer specialized care like orthodontics or oral surgery.
Low-cost dental clinics run by nonprofits or local health departments also exist in many areas. These clinics may limit services to preventive care or emergency extractions, or they may offer a full range of work. Call 211 or search your county health department website to find clinics near you.
Medicare Advantage plans and dental coverage
Medicare Advantage (Part C) plans are sold by private insurance companies and include Part A and Part B coverage plus additional benefits. Some Medicare Advantage plans include a dental benefit, usually covering cleanings and X-rays with a small copay, and covering a portion of larger work like fillings or crowns.
Dental coverage in Medicare Advantage plans varies widely. One plan might cover two cleanings per year with no copay and pay 50 percent of crowns. Another might cover one cleaning per year and pay nothing toward crowns. You must read the plan's details to know what is covered.
If you are thinking about switching to a Medicare Advantage plan partly for dental coverage, compare the dental benefit against the cost of buying a standalone dental plan. Sometimes a standalone plan costs less and covers more. Also check whether your current dentist is in the plan's network. Many Medicare Advantage plans have smaller networks than Original Medicare, so your dentist may not be included.
What to ask a dentist before you go
Because you will be paying out of pocket, call the dentist's office before your appointment and ask for an estimate in writing. Explain what work you need and ask the cost. A good office will give you a range or a specific number. If they will not, that is a sign to call another dentist.
Ask whether the dentist offers a payment plan if the cost is high. Some dentists let you pay in installments with no interest. Others use a third-party financing company like CareCredit, which charges interest if you do not pay in full within a set period. Understand the terms before you agree.
If you are on a tight budget, ask the dentist which work is urgent and which can wait. A cavity that is not causing pain can sometimes be monitored for a while. A tooth with an abscess (infection) usually needs treatment soon. Prioritizing urgent work can help you manage the cost.
Frequently Asked Questions
Does Medicare Part D cover dental work?
No. Part D covers prescription drugs only. Dental care is not covered by any part of Original Medicare. Some Medicare Advantage plans include dental benefits, but these are separate from Part D.
Will Medicare cover a tooth extraction if I have an infection?
Only if the extraction is performed in a hospital or surgical center and a doctor determines the infection is a medical emergency — for example, if it is spreading to your jaw or bloodstream. An extraction in a dental office, even for an infected tooth, is not covered.
Can I use my Medicare card at a dental office?
No. Medicare does not cover routine dental care, so your Medicare card will not reduce the cost. You will pay the full fee out of pocket or with a separate dental plan.
What is the cheapest way to get dental care as a Medicare beneficiary?
Community health centers that charge on a sliding scale are often the cheapest option if your income is low. Dental schools are also significantly cheaper than private dentists. If you need ongoing care, compare the cost of a standalone dental plan against paying out of pocket for the specific work you need.
Can I buy a dental plan after I turn 65?
Yes. Standalone dental plans are available to people of any age, including those on Medicare. You can buy them year-round, though some plans have waiting periods before they cover major work like crowns. Read the terms carefully to understand any waiting periods or exclusions.