Does Medicare Cover Dental?

10 Key Takeaways (Short Answers First)

Original Medicare (Parts A and B) covers virtually zero routine dental care. No cleanings, fillings, extractions, dentures, or implants. Period.

There are narrow medical exceptions where Medicare pays for dental — but only when your teeth are literally threatening your life (pre-transplant infections, cancer treatment complications, dialysis-related infections).

Medicare does not cover dental implants unless the implant is directly tied to reconstructive surgery for cancer or traumatic injury — not standard tooth replacement.

Medicare Advantage (Part C) plans are the only Medicare pathway to dental coverage, but benefits vary wildly and annual caps typically max out at $1,000–$2,000.

Medicaid covers dental for all children under 21 in every state — this is federally mandated and non-negotiable.

Adult Medicaid dental coverage is a state-by-state lottery. As of 2025, 33 states plus D.C. offer “enhanced” adult dental benefits, while 7 states cover emergencies only and 1 state covers almost nothing.

Only 41% of U.S. dentists accept Medicaid patients — so even with coverage, finding an appointment is a separate battle.

Medicare covers vision care only for medical conditions like glaucoma, diabetic retinopathy, and cataracts — not routine eye exams or glasses.

CMS decided in 2025 it will not expand the list of dental exceptions for 2026, dashing hopes that more clinical scenarios would qualify for Medicare dental payment.

Dental infections kill people. This isn’t hyperbole — untreated oral infections can lead to sepsis, endocarditis, and brain abscesses, yet the program designed to protect seniors explicitly excludes the care that prevents these outcomes.

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🚫 No, Original Medicare Does Not Cover Your Dental Cleaning (And Here’s Exactly What It Excludes)

In most cases, Medicare doesn’t cover dental services like routine cleanings, fillings, tooth extractions, or items like dentures and implants.

Let’s be painfully specific about what “doesn’t cover” means. You pay 100% out of pocket for:

❌ Not Covered by Original Medicare	Why It Matters
🪥 Routine cleanings & exams	Preventive care that catches problems early
🦷 Fillings (cavities)	Basic restorative work most adults need
🔧 Tooth extractions	Even a dangerously infected tooth
👑 Crowns & bridges	Structural restoration after damage
🦴 Dental implants	Replacement teeth that prevent bone loss
🫧 Dentures (partial or full)	Prosthetics for people who’ve lost teeth
🧹 Deep cleanings (scaling/root planing)	Treatment for gum disease
📐 Orthodontics	Braces or alignment correction
✨ Teeth whitening	Cosmetic — no surprise here

Medicare doesn’t cover items and services for the care, treatment, filling, removal, or replacement of teeth or structures directly supporting the teeth. The law specifically names the periodontium — gums, alveolar bone, cementum, and periodontal ligament — as excluded structures. Essentially, everything that holds your teeth in your head is considered “not Medicare’s problem.”

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⚠️ The Rare Exceptions Where Medicare Actually Pays for Dental (Life-Threatening Situations Only)

There is a narrow door through which dental services squeeze into Medicare coverage — but you practically need to be dying for it to open.

CMS clarified and codified that Medicare payment can be made for dental services that are “inextricably linked to, and substantially related and integral to the clinical success of, other covered services.”

Translation: if your bad tooth could literally cause a covered medical procedure to fail, Medicare might pay for the dental work. Here are the specific clinical scenarios currently recognized:

✅ Medicare-Covered Dental Scenario	What’s Actually Covered
💓 Pre-heart valve replacement	Oral exam + infection treatment before surgery
🫀 Pre-organ/bone marrow transplant	Dental clearance + treating active infections
🎗️ Cancer treatment (chemo, radiation, CAR-T)	Dental work to prevent or treat oral complications
🧬 Head & neck cancer treatment	Full dental care before, during, and after treatment
🧪 Kidney dialysis (ESRD patients)	Oral exams + infection treatment during dialysis
🦴 Tumor removal with jaw involvement	Dental ridge reconstruction done simultaneously
🩹 Jaw fracture	Stabilization/immobilization of teeth
🦷 Dislocated jaw joints	Dental splints as part of treatment

The critical 2026 update: CMS announced that it will not codify additional examples of clinical scenarios in which dental services may be paid by Medicare as part of its 2026 Physician Fee Schedule rulemaking. In plain English: advocates pushed for more exceptions, and CMS said no. The door isn’t widening anytime soon.

For covered dental services under Part B, you pay 20% of the Medicare-approved amount after meeting the $283 annual deductible. For Part A-covered inpatient hospital stays, you pay $0 after meeting the $1,676 Part A deductible for days 1–60.

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🏥 Medicare Advantage: Your Only Real Path to Dental Coverage Through Medicare (But Read the Fine Print)

If you want dental benefits connected to your Medicare, your one option is a Medicare Advantage plan (Part C) — a private insurance plan that replaces Original Medicare and often bundles extra benefits including dental, vision, and hearing.

Over 98% of Medicare Advantage plans are expected to offer vision benefits in 2026, and dental inclusion rates are similarly high. But “offering dental” and “covering what you actually need” are two very different things.

What Medicare Advantage dental typically looks like:

Coverage Tier	What’s Usually Included	What’s Usually Not
🟢 Preventive Only	Oral exams, cleanings, X-rays, fluoride	Fillings, crowns, dentures, implants
🟡 Comprehensive (Basic)	Preventive + fillings, simple extractions, root canals	Implants, complex surgery, orthodontics
🔵 Comprehensive (Enhanced)	All above + crowns, bridges, dentures at 50-70%	Implants usually capped or excluded

The hidden traps in Medicare Advantage dental:

Annual caps are devastatingly low. Most plans cap dental benefits at $1,000–$2,000 per year. A single crown costs $800–$1,500. One root canal runs $700–$1,200. One implant? $3,000–$6,000. You can blow through your entire annual dental maximum with a single procedure — and every dollar beyond that cap comes straight from your pocket.

2026 brought benefit cuts, not expansions. Effective January 1, 2026, UnitedHealthcare Medicare Advantage dental benefits underwent important changes: comprehensive plans added coinsurance to non-preventive services, and preventive-only plans dropped periodontal maintenance coverage. Translation: plans are getting stingier, not more generous.

Network restrictions limit your choices. Many members will have different dental plans in 2026. Members may no longer have comprehensive dental service coverage and may have plans with different coinsurance levels. If your longtime dentist isn’t in network, you may face full out-of-pocket costs even with a plan that advertises dental benefits.

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🦷 Does Medicare Cover Dental Implants? (Almost Certainly Not)

This is the question that breaks people’s hearts — and their bank accounts.

The definitive answer: In most cases, Medicare doesn’t cover dental services like routine cleanings, fillings, tooth extractions, or items like dentures and implants.

The razor-thin exception: Only if the implant is integral to reconstructive surgery directly tied to cancer treatment — not for cosmetic or standard tooth replacement.

Let’s be crystal clear about what this means:

Scenario	Covered?	Why
Lost a tooth to gum disease, want an implant	❌ No	Considered routine dental restoration
Need implant after jaw cancer surgery	✅ Possibly	“Inextricably linked” to covered medical procedure
Cracked tooth in an accident, need replacement	❌ No	Tooth replacement itself is excluded
Jaw reconstruction after traumatic injury	⚠️ Partial	Hospital costs maybe, implant itself usually no
Want implant-supported dentures for better fit	❌ No	Elective dental procedure

The cost reality without coverage: In 2026, dental implants are expected to cost $4,000–$6,000 per tooth, depending on your dentist, location, and whether additional work like bone grafts is required. Full-mouth reconstruction can easily reach $25,000–$50,000.

Even Medicare Advantage plans that advertise implant coverage typically impose 50% coinsurance with annual caps of $1,000–$2,000, leaving you responsible for the vast majority of the cost. Your procedure costs $3,500 total. Your plan covers 50% after a $50 deductible, but has a $1,000 annual maximum. You pay the $50 deductible, the plan pays $1,000, and you’re responsible for the remaining $2,450.

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🟢 Does Medicaid Cover Dental? (Yes for Kids, a Confusing Patchwork for Adults)

Unlike Medicare’s near-total dental exclusion, Medicaid actually does cover dental — but the extent depends entirely on your age and where you live.

For children under 21: full dental coverage in every state. No exceptions.

States are required to cover dental services for people with Medicaid under the age of 21, as part of the Early and Periodic Screening, Diagnostic and Treatment benefit. This includes exams, cleanings, fillings, X-rays, orthodontics when medically necessary, and essentially any dental treatment a child needs. This is one of Medicaid’s genuine strengths.

For adults: it’s a state-by-state roulette wheel.

States may choose whether or not to provide dental benefits to their adult Medicaid-eligible population. While most states provide at least emergency dental services for adults, less than half of the states provide comprehensive dental care. There are no minimum requirements for adult dental coverage.

Here’s the breakdown as of the most recent data:

Coverage Level	States	What Adults Get
🟢 Enhanced/Extensive (33 states + D.C.)	AK, CA, CO, CT, DC, HI, ID, IL, IA, ME, MD, MA, MI, MN, MT, NE, NH, NJ, NM, NY, NC, ND, OH, OR, PA, RI, SD, TN, UT, VT, VA, WA, WV, WI	Exams, cleanings, fillings, extractions, dentures, some major services
🟡 Limited (9 states)	AR, DE, IN, KS, KY, LA, OK, SC, WY	Some preventive + basic restorative, significant restrictions
🔴 Emergency Only (7 states)	AZ, FL, GA, MS, MO, NV, TX	Only covers extraction of infected teeth or treatment for severe pain
⚫ Virtually None (1 state)	AL	No adult dental benefits unless pregnant or postpartum

The access problem nobody solves: Even in states with generous Medicaid dental benefits, the share of U.S. dentists participating in Medicaid or CHIP is 41% as of 2024 — around the same as it was in 2015. The main reason? Medicaid fee-for-service reimbursement in most states falls far below 50% of dentist charges and 60% of private insurance reimbursement. Dentists literally lose money seeing Medicaid patients, so many simply don’t.

Eighteen states have expanded their adult dental offerings since 2021, which represents meaningful progress. But having coverage on paper means little when you can’t find a dentist who’ll accept your card.

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👁️ Does Medicare Cover Vision? (Same Story, Different Body Part)

Vision coverage under Original Medicare follows the same frustrating pattern as dental: medically necessary conditions only, no routine care.

Original Medicare (parts A and B) does not cover routine eye health exams, glasses or contact lenses. Medicare Part B covers eye exams, glasses or contacts only in specific, medically necessary situations.

What Medicare Part B actually covers for eyes:

✅ Covered (Medical Conditions Only)	Details	Your Cost
🩺 Diabetic retinopathy exam	Annual screening if you have diabetes	20% after $283 deductible
👁️ Glaucoma test	Annual test if high-risk (diabetes, family history, African American 50+, Hispanic 65+)	20% after deductible
🔬 Macular degeneration	Testing + certain injectable drug treatments	20% after deductible
🔪 Cataract surgery	Removal + intraocular lens implant	20% after deductible
👓 One pair of glasses post-cataract surgery	Standard frames only, or one set of contacts	20% after deductible
🏥 Emergency eye surgery	Medically necessary repair due to injury	Part A/B coverage applies

❌ Not Covered (Everything Else)	Your Cost
🔍 Routine eye exams	100% out of pocket
👓 Prescription eyeglasses	100% out of pocket
🔵 Contact lenses & fittings	100% out of pocket
✨ LASIK or refractive surgery	100% out of pocket
🕶️ Sunglasses (prescription or not)	100% out of pocket

The Medicare Advantage workaround: Just like dental, most Medicare Advantage plans include some vision benefits — typically an annual eye exam, plus an allowance of $100–$300 toward glasses or contacts. It’s not comprehensive, but it’s infinitely more than Original Medicare provides.

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💡 Smart Strategies When Medicare Won’t Cover Your Dental Needs

Since the system isn’t changing anytime soon, here’s what actually works for getting dental care on Medicare:

Compare Medicare Advantage plans ruthlessly during Annual Enrollment (Oct 15–Dec 7). Don’t just look at whether a plan “includes dental” — dig into the Summary of Benefits document. Check the annual cap, coinsurance percentages for major services, network restrictions, and whether your specific dentist participates. A plan with a $2,500 annual dental max and 50% coverage on major services is dramatically more useful than one capped at $750 with preventive care only.

Consider standalone dental insurance. Private dental plans for seniors typically run $20–$60/month and can be enrolled in any time of year — no Medicare enrollment period required. They won’t cover everything, but combining a standalone dental plan with Medicare Advantage dental creates a layered safety net.

Explore dental schools. Every accredited dental school offers supervised clinical care at 50–70% below private practice prices. The trade-off is longer appointments, since students work under faculty oversight, but the quality is clinically sound.

Check Federally Qualified Health Centers (FQHCs). These community health centers charge on a sliding fee scale based on income. Many include dental clinics and accept both Medicaid and uninsured patients.

Ask about payment plans. Most dental offices offer financing through CareCredit or in-house payment plans. For major work like implants, this can spread $5,000+ bills into manageable monthly payments.

If you’re dual-eligible for Medicare and Medicaid and live in a state with enhanced Medicaid dental benefits, your Medicaid coverage fills the massive dental gap that Medicare leaves open. This is one of the most valuable perks of dual eligibility that people consistently overlook.

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❓ Frequently Asked Questions

Q: Does Medicare Part B cover any dental services at all?

Only when dental work is directly tied to a covered medical procedure. Medicare payment can be made when dental services are inextricably linked to the clinical success of other Medicare-covered procedures. Examples include infection treatment before organ transplants, dental care during cancer treatment, and oral exams before dialysis. Routine dental of any kind is explicitly excluded.

Q: Reddit says Medicare covered someone’s dental surgery — how?

Context matters enormously. If someone had jaw surgery related to a fracture, tumor, or covered medical condition, Part A may have covered the hospital stay and the surgical component. The dental restoration afterward (implants, crowns, dentures) would still be excluded. People often conflate the medical surgical coverage with the dental component, creating the false impression that “Medicare paid for my dental.”

Q: Can I get free dental care as a senior on Medicare?

Not through Medicare itself. Your realistic free or low-cost options include: dental schools (deeply discounted supervised care), FQHCs (sliding scale fees), state-funded senior dental programs (varies by location), charitable organizations like Dental Lifeline Network (provides free care to elderly and disabled patients who can’t afford treatment), and your local Area Agency on Aging, which can connect you to community dental resources.

Q: Does Medicaid cover dental implants for adults?

Rarely. Even in states with extensive adult dental benefits, implants are generally considered elective and excluded from Medicaid coverage. A few states may cover implants when deemed medically necessary — for instance, following traumatic injury or cancer surgery — but this requires prior authorization and extensive documentation. Dentures are covered far more commonly than implants across state Medicaid programs.

Q: If dental disease causes a medical emergency, will Medicare cover the ER visit?

Yes — Medicare Part A covers emergency hospitalization regardless of the cause. If a dental abscess leads to sepsis requiring ICU admission, the hospital stay is covered. But the dental treatment itself (extracting the infected tooth, any follow-up dental work) remains excluded once you’re medically stable. You could survive a life-threatening dental infection on Medicare’s dime, then get discharged to handle the underlying dental problem entirely on your own.

Q: Is there any chance Congress adds dental to Medicare?

There have been proposals — most recently in the Build Back Better Act — to add dental, vision, and hearing to Medicare Part B. None have passed. CMS announced it will not expand dental payment examples for 2026. Advocacy organizations continue pushing, but as of February 2026, no legislation expanding routine Medicare dental benefits has been enacted.

Q: My Medicare Advantage plan cut dental benefits for 2026. Can they do that?

Yes. Medicare Advantage plans can change benefits annually. CMS requires them to cover everything Original Medicare covers, but supplemental benefits like dental are at the insurer’s discretion. This is precisely why reviewing your plan every year during Annual Enrollment is non-negotiable — the dental benefit that convinced you to enroll may no longer exist.

Q: Does Medicaid cover dental for pregnant women specifically?

Most states provide enhanced dental benefits for pregnant Medicaid enrollees, even some states that otherwise offer limited or emergency-only adult dental. Pregnancy-related dental care is increasingly recognized as essential for both maternal and infant health outcomes. Check your state’s specific pregnancy Medicaid benefits — you may qualify for comprehensive dental coverage during pregnancy and the postpartum period even if your state doesn’t cover adult dental generally.

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🔎 Bottom line: The gap between what science knows about oral health’s connection to overall health and what Medicare actually covers remains one of the program’s most indefensible failures. Your teeth don’t stop being medically relevant the day you turn 65 — but Medicare acts like they do. Until Congress updates a law written when dentistry was considered optional, your best defense is proactive planning: choose Medicare Advantage wisely, layer coverage strategically, and never skip preventive dental care just because the government decided your mouth isn’t part of your body.