Medicare's Basic Dental Coverage
Original Medicare (Parts A and B) does not pay for dentures, dental exams, cleanings, fillings, extractions, or root canals. Dental care is straightforward not included in what Medicare covers. This is true whether you need dentures because of tooth loss or decay, and it applies to both full dentures and partial dentures.
If you have Original Medicare and need dentures, you will pay the full cost out of pocket. A complete set of dentures typically costs between $1,000 and $3,000 per arch (upper or lower), though prices vary widely by location and the dentist you choose. Some dental schools offer dentures at lower cost if you are willing to have students do the work under supervision.
The one exception is if you need tooth extraction as part of a hospital stay — for example, if teeth need to come out before jaw surgery. In that case, the hospital extraction may be covered, but the dentures themselves still would not be.
Key Takeaways
- Original Medicare does not cover dentures, dental exams, cleanings, or any other routine dental care.
- Some Medicare Advantage plans include dental benefits that may cover part or all of denture costs, but coverage varies widely by plan.
- Standalone dental insurance and dental discount plans are available to people on Medicare and may reduce what you pay for dentures.
- Medicaid covers dentures in some states for people who meet income limits, so check your state's rules if you have both Medicare and Medicaid.
- Dental schools and community health centers sometimes offer reduced-cost dentures if cost is a barrier.
Medicare Advantage Plans and Dental Benefits
Some Medicare Advantage plans (Part C) do include dental coverage, and a small number cover dentures in full or in part. However, not all plans offer dental, and those that do vary enormously in what they cover and how much you pay. One plan might cover 50 percent of denture costs up to $500 per year; another might cover nothing for dentures but pay for cleanings.
If you are thinking about switching to a Medicare Advantage plan partly for dental coverage, read the plan's dental summary carefully. Look for the words "dentures" or "prosthodontics" specifically — do not assume that because a plan covers cleanings it also covers dentures. The plan document will list what is covered, what you pay, and any annual maximum (a cap on how much the plan will pay in a year).
You can change to a Medicare Advantage plan during the Annual Enrollment Period (October 15 to December 7 each year) or if you have a may have access to life event such as moving out of your plan's service area. If you already have a Medicare Advantage plan and want to check whether it covers dentures, call the plan directly — the member services number is on your insurance card.
Standalone Dental Insurance and Discount Plans
You can buy a separate dental insurance policy even if you have Original Medicare. These policies are sold by private insurers and work like any other insurance: you pay a monthly premium, and the plan covers a portion of your dental costs after you meet a deductible. Some plans cover dentures; others do not. Premiums for seniors typically range from $10 to $30 per month, though this varies by plan and your location.
Dental discount plans are different from insurance. You pay an annual membership fee (usually $80 to $200) and receive a discount card that gives you reduced rates at participating dentists — often 10 to 60 percent off. You pay the dentist directly at the discounted rate. These plans do not have deductibles or waiting periods, so you can use them right away. They work well if you need dentures soon and want to lower the cost when ready.
Both types of plans have waiting periods for major work like dentures. Insurance policies typically wait 6 to 12 months before covering dentures; discount plans usually have no waiting period. If you need dentures urgently, a discount plan may be faster, though you will still pay a significant portion of the cost yourself.
Medicaid Coverage for Dentures
If you have both Medicare and Medicaid (sometimes called "dual may be able to access"), Medicaid may cover dentures depending on your state. Medicaid is run by each state, so coverage rules differ. Some states cover dentures for adults; others do not. Some states cover only one set of dentures per lifetime; others cover replacements.
To find out whether your state's Medicaid covers dentures, contact your state Medicaid office or call 1-800-MEDICARE and ask them to connect you with your state program. You will need to provide proof of income and citizenship. If your state does cover dentures, Medicaid may pay the dentist directly, or you may need to pay and then request reimbursement.
What to Ask Your Dentist About Cost
Before you get dentures, ask your dentist for a written estimate that includes the cost of the dentures themselves, any tooth extractions needed, adjustments, and follow-up visits. Dentures often need adjustments in the first few months as your mouth heals and changes shape, and you should know whether those visits are included in the initial price or cost extra.
Ask whether the dentist offers a payment plan so you can spread the cost over several months. Many dental offices do, and some offer payment plans with no interest if you pay within a set time. Ask also whether the dentist is in-network with any dental insurance or discount plan you are considering — being in-network usually means a lower cost to you.
Reduced-Cost Dentures Through Community Resources
Dental schools in your area may offer dentures at 40 to 60 percent below the usual cost. The work is done by dental students under the supervision of a licensed instructor. Treatment takes longer than at a private practice — sometimes several months — but the quality is generally good. To find a dental school near you, search online for "dental school" plus your state name, or ask your doctor for a referral.
Community health centers (Federally may have access to Health Centers, or FQHCs) sometimes offer dental services on a sliding fee scale based on your income. If you have low income, you may pay very little or nothing. You can find a community health center near you by visiting findahealthcenter.hrsa.gov or calling 211 and asking for dental resources in your area.
Some nonprofit organizations and dental charities offer reduced-cost or free dentures to seniors who meet income requirements. These programs are less common than they once were, but they do exist. Ask your local Area Agency on Aging whether any such programs operate in your region.
Frequently Asked Questions
Can I use my Medicare Advantage dental benefit to pay for dentures if I switch plans?
It depends on the plan. Some Medicare Advantage plans have waiting periods for major dental work like dentures, meaning you cannot use the benefit for the first 6 to 12 months after you join. Check the plan's dental summary before you enroll to see whether dentures are covered and whether there is a waiting period.
If I buy a dental discount plan, will it work at any dentist?
No. Dental discount plans only work at dentists who have agreed to participate in the plan's network. Before you buy a discount plan, check whether dentists in your area are in the network and whether they offer dentures. The plan's website will have a dentist locator tool.
What happens if I need dentures but cannot afford them even with a discount plan?
Ask your dentist about payment plans with no interest, contact a dental school for reduced-cost treatment, or call 211 to find community health centers and nonprofit dental programs in your area. If you have Medicaid, check whether your state covers dentures. Some states also have emergency dental funds for low-income seniors.
Do I need to replace my dentures, and will Medicare pay for replacements?
Dentures typically last 5 to 10 years before they need to be replaced. Medicare does not cover replacement dentures any more than it covers the first set. If you have a Medicare Advantage plan with dental coverage, check whether replacements are covered and how often — some plans cover one replacement every five years.
Can I get dentures through the VA if I am a veteran?
The Department of Veterans Affairs (VA) may cover dentures if you are a veteran with service-connected dental conditions or if you meet other VA criteria. Contact your local VA medical center or call 1-800-MY-VA411 to ask about dental coverage. VA coverage is separate from Medicare.