Original Medicare does not cover routine dental care. That means cleanings, fillings, tooth extractions, dentures, and dental implants are not included in Part A or Part B. For the roughly 67 million Americans on Medicare, this gap is one of the most frustrating parts of the program. The good news is that limited exceptions exist under Original Medicare, Medicare Advantage plans commonly include dental benefits, and low-income beneficiaries may qualify for Medicaid dental coverage through Medicare Savings Programs.
This guide breaks down exactly what is and is not covered, how Medicare Advantage dental works in 2026, and what to do if you need dental care but cannot afford it.
What Original Medicare (Parts A and B) Does Not Cover
Medicare Part A covers hospital stays. Part B covers outpatient medical services. Neither covers routine dental services, including:
- Cleanings and exams
- X-rays for dental diagnosis
- Fillings
- Tooth extractions (except under specific medical exceptions)
- Root canals
- Crowns and bridges
- Dentures and partials
- Dental implants
- Periodontal (gum) treatment
This exclusion has been in place since Medicare was created in 1965. Congress has considered expanding dental coverage several times, but as of 2026 no broad expansion has passed.
When Original Medicare Does Cover Dental
There are narrow medical exceptions where Medicare Part A or Part B will pay for dental-related services. These are not routine dental care. They apply when dental treatment is directly connected to a covered medical procedure.
CMS expanded these exceptions starting in 2023, and they remain in effect for 2026. Medicare can pay for dental services that are "inextricably linked" to the clinical success of the following covered procedures:
| Covered Medical Situation | What Medicare May Cover |
|---|
| Organ transplant preparation | Dental exam and treatment to eliminate oral infections before a kidney, heart, or liver transplant |
| Heart valve replacement surgery | Oral exam and treatment to reduce infection risk before cardiac valve replacement |
| Cancer treatment | Dental services related to chemotherapy, CAR T-cell therapy, or high-dose bone-modifying agents |
| Kidney dialysis (ESRD) | Dental exam and treatment to address oral infections before or during Medicare-covered dialysis |
Outside of these situations, Medicare Part A may cover a dental exam required before a covered inpatient hospital procedure, but only if the exam itself is necessary for the procedure. Part A also covers emergency hospital treatment of jaw injuries or certain oral conditions that require inpatient care.
These exceptions are narrow. If you are not in one of the above situations, Original Medicare will not pay for your dental work.
Medicare Advantage (Part C) and Dental Coverage
Medicare Advantage plans are sold by private insurance companies and must cover everything Original Medicare covers. Many plans also add extra benefits, and dental is the most common addition.
In 2026, approximately 94% of Medicare Advantage plans include some dental coverage. However, coverage varies significantly by plan.
What Medicare Advantage Dental Typically Covers
Most plans cover preventive dental at 100% in-network and offer partial coverage for more extensive work:
| Service Category | Typical Coverage |
|---|
| Preventive care (cleanings, exams, X-rays) | 100% covered in-network, 1 to 2 visits per year |
| Basic restorative (fillings, simple extractions) | 50% to 80% covered after deductible |
| Major restorative (crowns, root canals) | 50% covered, subject to annual maximum |
| Dentures | Sometimes covered, often with waiting period |
| Implants | Rarely covered, or covered with very high cost share |
Annual Maximum Limits
Medicare Advantage dental plans cap how much they pay per year. In 2026, annual maximums typically range from $1,000 to $2,000, with an average around $1,500. Any unused benefit does not roll over to the next year. If your dental costs exceed the cap, you pay the rest out of pocket.
Some plans split dental benefits into "basic" and "enhanced" tiers, with the enhanced tier available as an optional add-on for a higher premium.
What to Watch for in 2026
Medicare Advantage plans have been cutting or restructuring extra benefits over the past two years due to CMS payment changes. Dental benefits are one of the areas affected. Before enrolling in or keeping a Medicare Advantage plan, compare the dental benefit details annually during Open Enrollment (October 15 through December 7).
Medicare Supplement (Medigap) and Dental
Medigap plans do not cover dental. Medigap is designed to fill in Medicare's cost-sharing gaps, like deductibles and coinsurance, not to add new benefit categories. If you have Original Medicare and a Medigap plan, you will need to purchase a separate standalone dental plan for dental coverage.
Medicaid and Dual-Eligible Dental Coverage
Low-income Medicare beneficiaries who also qualify for Medicaid may receive dental coverage through their state Medicaid program. This is called being "dual eligible."
Medicaid dental benefits vary by state. Most states cover emergency dental for adults. Many cover basic preventive care. Some states cover comprehensive dental including dentures and implants.
To be dual eligible, you must qualify for both Medicare and Medicaid. Medicare Savings Programs (MSPs) are one pathway that connects low-income Medicare beneficiaries to Medicaid benefits.
Medicare Savings Programs: Income Limits 2026
Medicare Savings Programs help low-income Medicare beneficiaries cover premiums, deductibles, and cost-sharing. Qualifying for an MSP can also make you eligible for full Medicaid in some states, which may include dental coverage.
There are four MSP levels, each with different income limits:
| Program | Who Qualifies | Monthly Income Limit (Single) | Monthly Income Limit (Married) | What It Covers |
|---|
| QMB (Qualified Medicare Beneficiary) | Below 100% FPL | Up to $1,350 | Up to $1,824 | Medicare Part A and B premiums, deductibles, and cost-sharing |
| SLMB (Specified Low-Income Medicare Beneficiary) | 100% to 120% FPL | Up to $1,616 | Up to $2,184 | Medicare Part B premium only |
| QI (Qualifying Individual) | 120% to 135% FPL | Up to $1,816 | Up to $2,455 | Medicare Part B premium only |
| QDWI (Qualified Disabled Working Individual) | Working people with disabilities | Up to $4,615 | Up to $6,239 | Medicare Part A premium |
Resource limits for QMB, SLMB, and QI are $9,950 for a single person and $14,910 for a married couple in 2026. Some states, including Connecticut, Hawaii, Alaska, and Maine, have higher income thresholds.
QMB enrollees are automatically enrolled in the Low Income Subsidy (LIS/Extra Help) for Part D prescription drug costs as well.
If you qualify for QMB, you may also qualify for your state's full Medicaid program, which could include dental benefits depending on your state's rules.
Standalone Dental Plans for Medicare Beneficiaries
If you are on Original Medicare or a Medicare Advantage plan with limited dental benefits, a standalone dental insurance plan is another option. These are not part of Medicare but are sold by private insurers.
Costs range from around $20 to $60 per month depending on coverage level. Many plans have a waiting period of 6 to 12 months before covering major services. A standalone dental plan can be a reasonable option if you anticipate needing crowns, root canals, or dentures.
Dental discount plans (sometimes called dental savings plans) are a lower-cost alternative. These are not insurance. You pay an annual membership fee and receive reduced rates at participating dentists. Discounts typically range from 10% to 60% off standard rates.
Low-Cost and Free Dental Options
For people who cannot afford dental insurance, several options exist:
Community Health Centers: Federally Qualified Health Centers (FQHCs) provide dental care on a sliding fee scale based on income. Services can cost as little as $20 to $40 per visit. Find locations at findahealthcenter.hrsa.gov.
Dental Schools: Dental school clinics offer cleanings, fillings, extractions, and sometimes more complex procedures at significantly reduced rates, typically 50% to 80% below private practice prices. Care is provided by supervised dental students.
State and Local Programs: Many states have dental assistance programs for seniors. Contact your State Health Insurance Assistance Program (SHIP) or your local Area Agency on Aging for referrals.
VA Dental: Veterans enrolled in VA health care may qualify for VA dental benefits depending on their service-connected disability rating or other eligibility factors.
How to Get the Most Dental Coverage as a Medicare Beneficiary
The best path depends on your income and situation:
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If your income is below 135% FPL: Apply for a Medicare Savings Program through your state Medicaid office. Qualifying may make you dual eligible and unlock Medicaid dental coverage.
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If you have a Medicare Advantage plan: Review your plan's dental benefit details each year during Open Enrollment. Look at the annual maximum, what services are covered, and whether your dentist is in-network.
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If you have Original Medicare and can afford a small premium: Consider adding a standalone dental plan or dental discount plan.
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If cost is the main barrier: Use community health centers, dental schools, or contact your SHIP counselor for local options.
Use our free benefits screener to check whether you may qualify for Medicare Savings Programs or Medicaid in your state based on your income and household size.
Frequently Asked Questions
Does Medicare cover teeth cleanings?
No. Routine cleanings are not covered by Original Medicare Part A or Part B. If you have a Medicare Advantage plan that includes dental benefits, cleanings are typically covered at 100% in-network up to once or twice per year.
Does Medicare cover dentures?
Original Medicare does not cover dentures. Some Medicare Advantage plans cover dentures, but many impose waiting periods or limit coverage to a certain dollar amount. Check your specific plan's Evidence of Coverage document for details.
Does Medicare cover dental implants?
Original Medicare does not cover dental implants. Some Medicare Advantage plans cover implants, but this is less common than coverage for other dental work. When implants are covered, you typically still pay a significant cost share, and the benefit counts toward your annual maximum.
Does Medicare cover tooth extractions?
Routine extractions are not covered by Original Medicare. Extractions may be covered if they are required as part of a covered medical procedure, such as preparation for an organ transplant or heart valve surgery. Medicare Advantage plans commonly cover simple extractions as a basic restorative service.
Does Medicare cover dental X-rays?
Original Medicare does not cover dental X-rays taken for dental diagnosis. Part B may cover diagnostic imaging ordered by a physician for a medical condition that happens to involve the jaw. Medicare Advantage dental plans typically include X-rays as part of preventive coverage.
What is the difference between Medicare Advantage dental and a standalone dental plan?
Medicare Advantage dental is included within (or added to) your Medicare Advantage plan. A standalone dental plan is purchased separately and works alongside Original Medicare or Medicare Advantage. Standalone plans are often more flexible in terms of dentist choice but add to your monthly premium costs.
How do I apply for a Medicare Savings Program?
You apply through your state Medicaid agency. Contact your State Health Insurance Assistance Program (SHIP) for free help with the application. You can also use our free screener to check your likely eligibility before applying.
Can I get dental coverage if I have both Medicare and Medicaid?
Yes. If you qualify for both Medicare and Medicaid (dual eligible), your dental coverage comes from Medicaid. Most states cover at least emergency dental for Medicaid-eligible adults, and many cover preventive and basic restorative services. Coverage varies by state.
