Oral health is critical as you age, and insurance coverage may dictate what procedures and associated out-of-pocket costs will hit your wallet harder. For instance, original Medicare, which consists of Part A and Part B, limits coverage to what’s medically necessary. Medicare Advantage, however, may offer more flexibility with coverage, as dental care is a common benefit with these private insurance plans.
[READ: What to Look for in a Good Medicare Dental Plan]
Does Original Medicare (Part A and Part B) Cover Dental?
No, original Medicare does not include routine dental care, such as cleanings and X-rays.
However, it can cover certain dental procedures when they are considered medically necessary as part of a larger covered medical treatment, such as jaw reconstruction due to cancer. Medicare also expanded its dental coverage in 2025 to ensure end-stage renal disease (ESRD) patients would receive equal access to essential dental care, regardless of whether they opt for dialysis or a kidney transplant.
Inpatient dental exceptions (Part A)
Medicare Part A (hospital insurance) handles inpatient dental coverage under two distinct scenarios:
— When both the hospital stay AND the dental work are covered: If a dental procedure is a direct, integrated part of a covered major medical surgery, Part A covers the entire event. For example, if you need teeth extracted as a necessary part of removing an oral tumor, Part A covers the hospital stay, the anesthesia and the dental surgery itself.
— When ONLY the hospital stay is covered (excluding the dentist’s fee): If you must be hospitalized for a standard dental procedure strictly because an underlying medical condition (like severe hemophilia or a serious heart condition) makes an outpatient procedure unsafe, Part A only acts as a safety net. In this case, Part A will cover the hospital room, the operating room and the anesthesia, but it will not pay the dentist’s professional fee for the actual dental work, which remains the patient’s financial responsibility.
Medically necessary outpatient care (Part B)
Medicare Part B (medical insurance) covers specific outpatient dental services that are deemed medically necessary to support a broader medical treatment plan.
Examples include:
— Dental or oral exams as part of a complete workup for organ transplant, cardiac valve replacement, valvuloplasty procedures or cancer treatment
— Dental ridge reconstruction as part of or after surgically removing a tumor
— Dental services to treat a jaw fracture
— Dental splints for dislocated jaw joints
In these cases, coverage is generally limited to the medically essential portion of care rather than ongoing or routine dental treatment.
Excluded services: What original Medicare never covers
While original Medicare provides dental coverage under specific conditions, it excludes coverage for services such as:
— Annual checkups: Regular cleanings, routine exams and X-rays
— Fixing cavities or infections: Standard fillings, root canals and crowns
— Replacing missing teeth: Complete or partial dentures, dental bridges and dental implants
— Standard oral upkeep: Nonemergency tooth extractions
[Read: What Medicare Doesn’t Cover and How to Manage Costs]
Does Medicare Advantage (Part C) Cover Routine Dental Care?
Yes, unlike original Medicare, Medicare Advantage plans typically offer some dental care as well as limited vision and hearing coverage.
“Nearly every Medicare Advantage plan offers dental benefits, which are generally more comprehensive than they were five years ago,” says Michael Adelberg, the executive director of the National Association of Dental Plans in Dallas. “Keep in mind, plans differ in their networks and coverage of specific services. If there is a particular provider or procedure that is important to you, ask about it before selecting a plan.”
Common dental benefits included in Medicare Advantage plans
Because Medicare Advantage plans are offered by private insurance companies, coverage, costs, provider networks and benefit limits can vary significantly.
However, most Medicare Advantage plans cover:
— Preventive care: Routine cleanings, oral exams and X-rays
— Basic restorative care: Fillings and simple tooth extractions
— Major restorative care: Root canals, crowns, dentures and sometimes single or partial dental implants
Understanding dental coverage caps and annual limits
One of the most important details to review in a Medicare Advantage dental benefit is the annual benefit maximum, the total amount the plan will pay toward dental care each year. According to KFF
, in 2026, 98% of plans offer some dental benefits, but these perks are often bound by the average annual cap of around $1,300. Once that limit is reached, beneficiaries are responsible for all remaining dental costs out of pocket until benefits reset the following year.
In addition, while preventive care is often covered at or near 100%, major restorative work comes with higher copays, separate spending limits and even as much as 50% coinsurance, KFF notes. These major services can cost thousands of dollars, making it possible to reach a plan’s annual coverage cap quickly. Plans may also require members to use in-network dentists or satisfy waiting periods before major dental work is covered.
[READ: Benefits Offered by Medicare Advantage]
Original Medicare vs. Medicare Advantage Dental Benefits
How Much Does Dental Care Cost Under Medicare and Medicare Advantage?
Just as important as finding out what is and is not covered in any dental plan is finding out how much the coverage will cost. Keep in mind that cost includes any monthly premiums, deductibles, cost sharing and other out-of-pocket expenses.
The costs associated with dental work under original Medicare follow the same cost-sharing structure as other covered medical services.
— Part A: Covered dental services tied to an inpatient hospital stay are subject to the $1,736 deductible per benefit period in 2026, along with any applicable hospital coinsurance for extended stays.
— Part B: After meeting the annual deductible of $283 in 2026, beneficiaries typically pay 20% of the Medicare-approved amount for covered dental-related services.
“Most dental benefits in Medicare Advantage plans share costs with their members. While preventive services are usually covered at 100%, major and restorative services usually are not. Seniors should understand how costs will be shared in the dental benefit of the plan they choose,” Adelberg advises.
Unfortunately, there is no crystal ball to help you figure out next year’s needs, but the next best thing is to speak to your dentist about anything specific they see coming up and plan accordingly.
Best Alternatives for Senior Dental Coverage
Medicare is not the only option you have when looking for dental insurance.
For instance, you may be eligible for coverage through employer-sponsored retiree plans or Medicaid.
Alternatively, if the Medicare plan that is right for you does not include the dental benefits you need, consider a private dental plan. These plans typically cost $25 to $100 a month, depending on the type of coverage you select.
Preventive services, such as routine cleanings, are usually 100% covered under private dental insurance. Other services, such as comprehensive dental work, offer cost-sharing options. For example, if you were to undergo a bridge procedure, then private health insurance would typically cover 50% to 80% of the cost.
Private dental insurance options include:
— Dental HMO (health maintenance organization): These plans allow members to visit dentists in their approved network at lower costs. HMO plans typically do not charge any deductibles, but you may need to pay a copayment when you visit the dentist.
— Dental PPO (preferred provider organization): Whether you visit an in-network or out-of-network dentist, you will be covered with a PPO. However, the standard fees at a dental office for patients who are out-of-network can be more expensive than the in-network contracted fees.
— Discount dental plans: These plans are not insurance but do provide access to dental services at a discounted rate for a monthly or annual fee. There is generally no paperwork, annual limits or deductibles, but you must visit a participating dentist to receive the discount. Additionally, you might pay more for treatment costs than with HMO or PPO plans.
There is a possible waiting period for most comprehensive dental procedures under private insurance plans. A good place to begin your search is the Health Insurance Marketplace. You can also ask your dentist which plans they accept.
Importance of Dental Health for Seniors
Oral health is often treated as secondary, but it’s a critical part of aging well. Older adults need to be aware that dental issues — such as cavities, gum disease and tooth loss — can lead to a multitude of costly dental procedures and potentially necessary dental appliances, such as implants, crowns or dentures. Plus, gum disease is more common in people with diabetes and cardiovascular disease.
“Good dental care is an important part of maintaining your overall health,” says Mary Johnson, a retired Medicare policy analyst with The Senior Citizens League, a nonpartisan group advocating for seniors, in Alexandria, Virginia.
There aren’t many numbers on how many seniors go to the dentist, but according to the Centers for Disease Control and Prevention, in 2022, 63.7% of adults age 65 and older visited the dentist in the past 12 months, with women (64.9%) more likely than men (62.3%) to have had a dental visit.
So, while looking at the pros and cons of dental plans, keep in mind that you aren’t just considering coverage for simple fillings; you’re taking care of your health as a whole.
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Update 06/01/26: This story was previously published at an earlier date and has been updated with new information.
