Original Medicare does not cover the costs of dental care except in limited circumstances. This includes the cost of dental aids, such as dentures. However, Medicare Advantage plans may offer dental coverage.

Medicare is a federal insurance program that helps provide healthcare to people who are ages 65 years old and older. It is also available to younger individuals with disabilities or certain medical conditions, such as end stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS).

The Medicare program has four parts:

  • Part A hospital insurance
  • Part B medical insurance
  • Part C (Medicare Advantage), which offers an alternative to Original Medicare (parts A and B)
  • Part D prescription drug insurance

Medicare negotiates prices with hospitals, doctors, and insurance companies.

Original Medicare plans do not include extra benefits, such as dental, vision, or hearing. However, many Medicare Advantage plans may offer these and other extra benefits.

This article discusses Medicare dental benefits, including coverage for dentures. It also looks at costs and options for financial aid.

Glossary of Medicare terms

We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:

  • Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
  • Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
  • Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
  • Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
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Most dental coverage relating to Medicare is for emergency dental services while a person is in the hospital. For example, someone could have oral cancer and need dental extractions before an oral surgeon could remove a cancerous area.

Original Medicare does not cover:

  • dental cleanings
  • fillings
  • plates
  • dentures
  • tooth extractions

However, although Original Medicare does not cover the cost of dentures, a person might get coverage through a Medicare Advantage (Part C) plan.

Find out about Original Medicare vs. Medicare Advantage.

Some Medicare Advantage plans offer additional services, including dental, hearing, and vision coverage.

According to KFF, nearly 31 million people enrolled in Medicare Advantage plans in 2023. This accounts for around 51% of the eligible Medicare population.

KFF also notes that as of 2018, around 14% of adults over 65 years old have no natural teeth. KFF looked at various Medicare Advantage plans that include dental coverage and found that 5 in 10 plans covered dentures. Additionally, most limited members to one set of dentures every 5 years.

A few key points may indicate if a Medicare Advantage plan might offer coverage for dentures.

Preventive versus comprehensive

Preventive dental services focus on preventing dental issues before they begin. Comprehensive dental services can also diagnose and treat existing dental issues.

Preventive dental services include cleanings, fillings, and some extractions. Comprehensive services usually include more extensive dental work, such as partial or full dentures.

Some Medicare Advantage plans offer coverage for preventive services only.

In-network versus out-of-network

Medicare Advantage plans often require a person to see dentists in the company’s network before the plan will pay. Individuals need to ensure their dental provider of choice is included in this provider network.

Co-pays and coinsurance

Some Medicare Advantage plans will pay for a portion of dental costs. When KFF looked into various plans in 2021, it found that cost-sharing varies among them. The shared cost ranges from a copayment of $0 to one of $500. Plans may also include coinsurance costs of 50% to 70%.

However, other plans may offer a maximum benefit, paying for all costs up to a certain amount.

Maximum benefit

Most Medicare Advantage plans will have a cap or maximum benefit of costs they will cover for dental services. For example, certain plans may have a cap that ranges from around $1,350 to over $2,500. It is important that a person checks with their plan of choice for the annual maximum amount paid.

According to KFF, the average annual limit for dental coverage in 2021 was $1,300.

Some companies may also limit how often they will pay for denture replacements. Because dentures can be expensive, it is important to consider the maximum benefit when selecting a plan.

Several types of dentures are available, and costs vary depending on various factors, such as the type, materials, and quality.

Fixed versus removable dentures

Fixed dentures, or implant-supported dentures, are secured to the mouth with dental implants, which are surgically implanted posts into the jaw.

A person can take out removable dentures, clean them, and put them back daily.

Fixed dentures may be more expensive due to the more extensive process of securing and creating them.

Partial or full dentures

Full dentures give the look of replacing every tooth in the upper or lower portion of the mouth.

Partial dentures may replace several missing teeth in the upper or lower jaw.

Materials

Dentures may comprise acrylic resin (plastic) or porcelain, while partial dentures also have some metal components. As a general rule, porcelain dentures may be slightly more expensive but may be more durable than their acrylic resin counterparts.

Medicare Advantage plans offer various types of coverage for dental services. Most plans will not cover the full denture costs.

Some plan coverage and cost examples for 2024, using the Find a Medicare Plan tool, are shown in the chart below.

City, StatePlan nameCostsDenture coverage
Trenton, New JerseyHumanaChoice PPO Medicare Advantage Plan• $0 monthly premium
• $40.70 to add optional package, including dental
• $0 copay both in and out-of-network
• limits may apply
Tulsa, OklahomaGenerations Classic Rewards (HMO)$0 monthly premium0% to 20% coinsurance
Washington D.C. AARP Medicare Advantage from UHC (PPO)$0 monthly premium0% to 50% coinsurance
San Diego, CaliforniaSharp Direct Advantage VIP Plan (HMO)• $0 monthly premium
• $50 per month to add optional package, including dental
$20 to $495 copay
Tampa, FloridaOptimum Platinum Plan (HMO)$0 monthly premium$0 copay

All monthly premiums listed are on top of the Medicare Part B monthly premium, which is $174.20 in 2024.

There are other options a person may access to get dental coverage or reduced dental costs.

Nearby dental schools or clinics

Some dental schools or clinics have a prosthodontics department where students learn to fit dentures. These schools may offer discounted dentures or services in preparation for molding the dentures.

Stand-alone dental plans

Some health insurance companies offer stand-alone dental plans for older people. For a monthly premium, a person may get coverage similar to or greater than Medicare Advantage plans.

Discount dental plans

These plans come from organizations that make dentures or provide dental care. They have a network of providers where a person can get discounted services on comprehensive dental needs, including dentures.

Medicaid

Medicaid is a state-based insurance plan for people on lower incomes. Additionally, some states may provide additional coverage for dental services, which may include dentures. However, these benefits vary by state.

While Original Medicare does not offer coverage for dentures, Medicare Advantage plans may help pay for the costs. However, even with maximum benefits, Medicare Advantage plans may not fully pay for dentures.

If a person does not get dental coverage through a Medicare Advantage plan, there are other options that may help with the cost of dentures.