About Your Teeth: Understanding Medicare Dental Coverage
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Last Updated April 27, 2026
Written by Helena Foutz
Medicare Broker Licensed in CA, AK, AR & 9 other states
Does Medicare Cover Dental Care?
Some Medicare Advantage plans include dental coverage, but Original Medicare only covers dental in extreme situations, like if you're having cancer treatment or an organ implant. You're on your own for regular teeth cleanings, crowns, cavities, etc. I like to tell people, "Medicare only covers you from the neck down!" The gap in dental, vision, and hearing coverage has been a long-running debate, and there are strong arguments on both sides of whether Medicare should cover dental, vision, and hearing. So what should you do?
Choosing the Right Dental Insurance
If you already have a dentist and want to keep your dentist, find out which insurance is accepted. Do they take HMOs, like Delta or Liberty Dental? Or do they accept only PPOs? This is an important question, since there's a major cost difference. A local agent who specializes in dental plans can help you compare your options.
The Missing Tooth Clause
Another question is, do you have any deferred maintenance going on? California and many other states have a "Missing Tooth Clause," meaning if you get insurance after you've already lost a tooth, the insurance won't pay for that tooth!
Types of Dental Insurance: DHMO vs. PPO
- Less expensive, generally a yearly fee
- Fixed costs, set by a dental fee schedule
- No yearly limit
- Immediate coverage for major treatments, like crowns or dentures
- Less dentists take this, must be in network
- More expensive, usually a monthly fee
- Cost is a fixed percentage of the treatment
- Yearly maximum, from $500 to $10,000
- Can have a waiting period of up to 12 months, depending on the plan
- Most dentists take it, even out of network
Getting Started with Dental Coverage
If you know you'd already like a PPO plan and wonder how much to get, ask the dentist. The good news is, you can get dental insurance at any time of year, it's always open enrollment for your teeth! If you're also wondering about vision coverage or want to understand how Medicare enrollment periods work, those are important pieces to coordinate alongside dental.
How can I get dental and vision coverage with Medicare?
I like to say Original Medicare only covers you from the neck down, so no glasses, no dentures, or hearing aids! (They will cover the inside of your head, lol.) But if you want a side of dental and vision with your Medicare, then look to a Medicare Advantage (MA) plan. Many MA plans offer dental and vision, and it pays to shop around. But let your broker be your personal shopper - it doesn't cost you anything, and he or she knows all the plans!Helena Foutz, RSSA is a Medicare Broker Licensed in AK, AR, AZ, CA, KS, MI, MO, NE, NV, OH, OR, TX and WA. Get in touch with Helena through her Medicare broker listing here.