Does Medicare Cover Dentures?
- Older adults with tooth loss often ask, "Does Medicare cover dentures?" Read on to learn what dental services Original Medicare and Medicare Advantage pay for.
Some older adults who experience tooth loss opt for dentures to replace missing teeth. In 2020, nearly 41 million Americans used dentures. Many people ask, "Does Medicare cover dentures?" and are surprised to learn they must pay for them out of pocket. Full or partial dentures aren't covered through Original Medicare, although some Medicare Advantage plans may pay for this expense.
Does Medicare Cover Dentures?
Dentures aren't considered a medically necessary expense through Medicare Parts A or B. This means that if you have Original Medicare through the federal government, you must pay 100% of the costs of dentures.
Dentures may be eligible for coverage in some Medicare Advantage (Part C) plans provided by private insurers.
Are Any Dental Services Covered by Original Medicare?
According to the Kaiser Family Foundation, 65% of people on Medicare don't have any dental coverage. In 2016, almost 20% of beneficiaries who needed dental care spent more than $1,000 out of pocket on these services.
Original Medicare doesn't cover any of the following dental services or supplies:
- Dental plates and other devices
In some cases, Part A hospital insurance pays for dental procedures if you require them during an inpatient hospital stay because of a health condition. This may include:
- Procedures needed before radiation treatment involving the jaw
- Oral examinations needed before kidney transplants or heart valve replacements
Do You Need Dentures?
Older adults lose teeth because of injury, tooth decay and gum disease. Missing teeth can make it hard to chew food, affecting diet and nutrition. It can also make people self-conscious about how they look and affect whether they smile or even socialize.
About 15% of Americans over the age of 65 don't have any teeth at all. Full or partial dentures, also known as false teeth, can be inserted in the mouth to replace missing teeth.
Denture Coverage Through Medicare Advantage
Medicare covers dentures through some, but not all, Medicare Advantage plans. These plans are provided by private insurance companies to give Americans a greater choice of health coverage beyond Original Medicare Parts A and B.
Medicare Advantage plans, known as Medicare Part C, cover the same services as Medicare Parts A and B and additional supplemental benefits. These extra benefits may include dental, vision, hearing and fitness. The specific benefits vary by plan, and not all plans are available in every service area.
About 60% of Medicare Advantage subscribers had some dental coverage through their plan in 2016, reports the Kaiser Family Foundation.
- 19% had preventive coverage for dental cleanings, oral exams, fluoride treatments and X-rays
- 42% had preventive coverage in addition to benefits for fillings, crowns, implants and dentures
Medicare Advantage plans differ significantly in terms of coverage, premiums, deductibles and cost-sharing. If you need Medicare to cover dentures, be sure to compare plans carefully before enrolling to ensure that you find the best policy for your needs.