Does Medicare Cover Dental Care? What You Need to Know

You’ve spent years putting away money for retirement. Maybe you’ve pictured a few trips, more time with family or simply waking up on a Monday morning with nowhere you have to be. Whatever retirement looks like for you, planning for your health and everyday expenses can help you make the most of it.

Dental care might not be at the top of your retirement planning list. If you’ll have Medicare, it’s easy to assume your health is taken care of. But did you know that Original Medicare generally doesn’t cover routine dental care? That includes cleanings, exams, as well as dentures and dental implants.

There are a few exceptions. Medicare may cover certain dental services when they’re directly tied to medical treatment that Medicare covers. But for the dental care you’re more likely to need from year to year, you’ll generally need another way to pay for it.

Your teeth don’t know you’re retired or on a fixed budget. A filling, crown or other major dental needs are more likely as you age. Those costs will need to fit somewhere in the retirement budget you worked hard to build. Knowing what Medicare does and doesn’t cover can help you plan for dental expenses before you need care.

Understanding Dental Coverage with Different Types of Medicare

If Medicare feels like it comes with its own language, you’re not imagining it. There’s Original Medicare, Medicare Advantage, Medigap —and plenty of fine print in between. The good news? You don’t need to become an expert to understand how dental coverage works with different types of Medicare.

Type of Medicare	What it does	What to know about dental
Original Medicare (Parts A and B)	Helps cover hospital care, doctor visits, outpatient care and other Medicare-covered health services.	Generally doesn’t cover routine dental care. It may cover certain dental services when they’re directly connected to covered medical treatment.
Medicare Advantage (Part C)	Provides your Part A and Part B benefits through a Medicare-approved private insurer.	Many plans offer additional dental benefits, but what’s covered and what you pay varies by plan.
Medigap	Helps with certain out-of-pocket costs that Original Medicare doesn’t pay.	Generally doesn’t include routine dental coverage.

Medicare Part A vs. Medicare Part B

Medicare Part A and Part B work together as Original Medicare, but they cover different sides of your medical care. That matters in the limited situations when Medicare may cover dental services.

Part A might help with certain dental services when you’re admitted to a hospital. Part B might cover certain dental services provided in an outpatient setting when they’re directly tied to covered medical care. Having dental work done in a hospital doesn’t automatically make it a Medicare-covered service; it must be directly related to a covered medical treatment.

For most of the care you get at the dentist, Original Medicare generally doesn’t provide coverage. That includes:

• Dental exams
• Cleanings
• Dental X-rays
• Fillings
• Tooth extractions
• Root canals
• Crowns
• Dentures
• Dental implants

Medicare Advantage

Medicare Advantage is where you might have more dental benefits to work with. Many Medicare Advantage plans offer benefits beyond Original Medicare, including preventive care like exams and cleanings. Depending on the plan, you may also have benefits for other dental services.

Here’s where reading the fine print pays off. Two Medicare Advantage plans can both include dental benefits and still offer very different coverage. One may cover only preventive care, while another may help with fillings, crowns or dentures. A plan may also have an annual benefit limit, pay only part of the cost or require you to see a dentist in its network.

Before enrolling in a Medicare Advantage plan, look beyond whether a plan simply checks the “dental” box. Check which dental services are covered, what you’ll pay and whether there are limits or requirements for the care you think you’ll need.

Medigap

With a name like Medigap, you might reasonably expect it to fill the dental gap, too. But Medigap doesn’t cover routine dental care. These plans work alongside Original Medicare to help with certain costs it leaves behind, such as deductibles, copays and coinsurance.

That means adding Medigap to Original Medicare doesn’t necessarily solve the question of how you’ll pay for cleanings, fillings and other routine dental care. You may still want to consider another source of dental coverage as part of your retirement plan.

Why Dental Benefits Matter as You Get Older

Your calendar might look a lot different after retirement, but your dentist appointments probably aren’t disappearing from it. In fact, keeping up with dental care can become even more important as you get older.

Think about the teeth you have today. Maybe there’s a crown you’ve had for years, a tooth your dentist has been keeping an eye on or a little gum recession that hasn’t caused much trouble. None of those things automatically mean bigger dental work is ahead. But your dental needs can change over time, which makes staying on top of routine care especially helpful.

Regular exams and cleanings give your dentist a chance to keep an eye on those changes, too. They can catch cavities and look for signs of other problems before you notice something yourself. And if something does need attention, finding it earlier could mean you have more options for taking care of it.

Your oral health can also be affected by other things going on in your life. Dry mouth, for example, can be a side effect of many medications and can make cavities more likely because saliva helps protect your teeth. Existing dental work may need attention, too. That filling or crown you got years ago wasn’t necessarily meant to be the last conversation you ever had about that tooth.

Dental benefits can help make that care easier to plan for, from keeping regular appointments on your calendar to getting treatment when you need it.

Ways to Plan for Dental Costs in Retirement

Retirement comes with enough unknowns. How you’ll pay for dental care doesn’t have to be one of them.

You have several options for paying for dental care in retirement. Depending on the kind of help you want, each option works a little differently:

• Choose a Medicare Advantage plan with dental benefits.
  This keeps your dental benefits bundled with your Medicare coverage. As we covered earlier, benefits vary by plan, so make sure the dental coverage gives you the level of help you’re looking for.
• Use a dental discount program.
  These programs aren’t insurance. Instead, you pay a membership fee for access to discounted rates from participating dentists and pay those lowered costs yourself. Delta Dental of Arizona Patient Direct is one option for Arizonans looking to save on dental care this way.
• Buy an individual dental plan.
  This option lets you choose dental coverage separately from your Medicare health coverage. You can compare different levels of coverage and prices and choose a plan that fits your needs and budgets.

A little planning now can make dental costs feel less uncertain later. With a better idea of how you want to pay for care, you can head into retirement knowing you’ve already thought through one more piece of your health care planning.

Choosing Dental Coverage That Works for Your Retirement

If you want more control over your dental insurance details, buying an individual dental plan separately from Medicare health coverage gives you the freedom to find a plan that that best fits your budget and specific oral health needs.

You can compare individual dental plans based on the things that matter most to you, including monthly premiums, covered services, out-of-pocket costs and access to dentists. Think about the care you expect to need, how much you want to budget each month and whether your preferred dentist is in the plan’s network.

Knowing what matters to you makes it easier to narrow down your options. Delta Dental of Arizona offers several individual dental plans to choose from, plus access to the largest network of dentists in Arizona and nationwide. You can even add individual vision coverage to plans.

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