Does Medicare Cover Dental Implants?

If you’re on Medicare and you need major dental work, you might be wondering what kind of dental benefits you have. In short, does Medicare include dental insurance, and does it cover dental implants? 

Quick Answer: Medicare and Dental Implants:

No, Medicare doesn't cover dental implants.

What exactly are dental implants? Dental implants are artificial teeth screwed, or implanted, into the jawbone and attached to a metal post. Implants are a better alternative to dentures but can be very expensive; so of course, you’re wondering whether your Medicare will pay for them.

Original Medicare does not cover dental procedures — unless they involve injury or illness. Dental procedures are only covered by Medicare in the hospital, after a traumatic event and if the procedure is medical, not cosmetic. If you need advanced dental work done in the hospital, Medicare will cover the inpatient care under Part A but not the dental procedure itself. 

Best Medicare Plans

What Is Medicare and How Does it Work?

If you’re 65 or older, chances are you’ve got Medicare. Medicare is insurance for those who otherwise might not qualify for private coverage. It’s sponsored by the federal government and available to everyone 65 or older who qualifies.

Medicare Part A — hospitalization — is mandatory. The best part is, it’s free. But Medicare Part A is just the beginning. Today’s Medicare covers so much more than just hospitalization.

The 4 basic parts to Medicare are:

• Part A
• Part B
• Part C
• Part D

Part A

Part A covers hospitalization and is free to all who qualify for Medicare. If you qualify for Medicare, Part A is mandatory, and you get it automatically. It also covers costs for:

• Skilled nursing facilities
• Home care
• Hospice care
  

Part B

Medicare Part B covers outpatient and medical coverage. These services include:

• Doctor’s visits
• Home health services
• Ambulance services
• X-rays and lab tests
• Durable medical equipment
  

Part C

Medicare Part C includes plans like Medicare Advantage, which will be covered in more depth later. Medicare Advantage is a private plan and incorporates many of the other parts in just one plan.

Part D

Medicare Part D covers prescription drug medications. For those enrolled in a Medicare stand-alone plan, Part D is administered by private companies. Part D requires a monthly premium.

While Medicare is predominantly insurance coverage for people 65 and older, it also applies to people with disabilities. If you are on Social Security Disability Insurance (SSDI), then you also qualify for Medicare. People with end-stage renal disease (ESRD), as well as those with permanent kidney failure, also qualify for Medicare.

While Medicare Part A is free, the other parts are not. Stand-alone parts B and D require monthly premiums. If you have Part A and receive Social Security benefits, premiums for Part B are automatically deducted from your Social Security check. The 2021 cost for Part B is $148.50.

Does Medicare Cover Dental?

Original Medicare and plans A, B and D do not include dental coverage. If you’re looking to add dental care to your original Medicare coverage, there are plans available from private providers. If you’re on Medicare and you need dental coverage, the bad news is that Medigap or Medicare Supplement Plans, aka Part G, does not include dental coverage. The good news is that many Medicare Advantage Plans do.

A Medicare Advantage Plan, Part C, does provide dental coverage, but it only covers the basics. Items covered in a Part C dental plan include:

• Checkups
• Cleanings
• Fillings
• Crowns 
• Root canals
• X-rays
• Simple extractions
• Periodontics
• Oral exams

Like with Parts B and D, dental insurance in a Part C plan costs extra and is additional coverage. Just like with private insurance, the dental coverage you receive depends specifically on your type of plan.

Most dental insurance plans operate on a 100-80-50 basis. That is to say that the plan will pay for 100% of routine dental work like checkups and cleanings, 80% for basic procedures like root canals and fillings and 50% for more complicated procedures like bridges and crowns.

Types of Medicare Plans

There are 2 basic types of Medicare plans.

Medicare Supplement Plans

A Medicare supplement plan, or Medigap, fills in the gaps where original Medicare leaves off. A Medicare supplement plans helps pay some of the costs left out of original Medicare like:

• Copayments
• Coinsurance
• Deductibles

Medigap plans also include some items original Medicare does not, like travel coverage. After original Medicare pays its part, Medigap kicks in. Some things you should know about a Medigap plan include:

1. To have Medigap, first you must have Medicare Parts A and B.
2. Medigap plans are not the same as Medicare Advantage. Medigap only supplements the benefits you have already, it does not add to them like Medicare Advantage.
3. Medigap has a separate cost than Parts B and D. This premium gets paid to a private insurance company.
4. Medigap policies get sold separately, so if you and your spouse both want it, you have to pay separate premiums.
5. Medigap policies are guaranteed renewable.

In short, a Medigap, or Medicare supplement plan, is for people who are happy with the coverage Medicare provides but want to fill in the gaps where it does not pay. Medigap plans do not provide additional coverage. Medigap plans also do not include dental implant insurance.

Medicare Advantage Plans

Medicare Advantage plans, much like Medigap plans, offer financial assistance in the ways of coinsurance and copays. Where Medigap leaves off, however, is where Medicare Advantage steps in. Medicare Advantage plans provide additional coverage like vision and dental. They are often regarded as an alternative to original Medicare.

When it comes to dental insurance, Medicare Advantage plans cover the basics, like checkups, cleanings and fillings, but they do not typically cover implants. Implants are one of the most expensive dental procedures and typically are not covered by basic insurance, including preventative and diagnostic coverage. Some types of comprehensive dental insurance, or full coverage, do cover implants. On top of the basics like X-rays, crowns and bridges, comprehensive coverage covers procedures like:

• Complex extractions
• Partial and complete dentures 
• Dental implants

Be aware that purchasing comprehensive coverage does require an additional monthly premium and will not pay for the full amount. Plans are typically capped in the $1,500 range. After that, you have to pay the difference. Make sure that the plan you purchase specifically covers implants.

How To Compare Medicare Plans

When deciding which type of Medicare plan is best for you, first consider what exactly it is you’re looking for. If you supplement your Medicare with a private plan or insurance through your employer, you may not need additional coverage such as vision and dental. You may be looking just to fill in the financial holes in your Medicare coverage. If this is the case, then a Medicare supplement plan like Meigap is the best route for you.

Medigap pays for:

• Coinsurance
• Copays
• Deductibles

Remember, original Medicare pays only 80% of your medical costs. If you feel you’re going to be using your Medicare extensively, you’re going to want to bridge the financial gap.

On the other hand, if it’s more coverage you’re looking for, like dental, then a Medicare Advantage plan is the best way to go. Medicare Advantage plans are sold by private insurers, and you can shop around for the best price and plans. Medicare Advantage offers all the same coverage as original Medicare and then some. Having Medicare Advantage does not mean giving up your original Medicare benefits, it means adding to them.

Medicare Advantage plans include:

• Medicare Part A
• Part B
• Vision
• Hearing
• Dental
• Prescription drugs

Medicare Advantage plans cap annual out-of-pocket expenses at $7,550 for in-network services and $11,300 for out-of-network.

How To Sign Up for Medicare

The best part about Medicare is that once you turn 65, you’re enrolled automatically — if you qualify. If you’re receiving Social Security benefits, you get enrolled automatically after 2 years.

While original Medicare Part A is free, you will be responsible for Parts B and D monthly premiums. If you opt instead for a Medicare Advantage plan, you’ll have to shop around as these are offered by private insurance companies.

If for some reason you are not enrolled automatically, you can:

1. Go online to www.SocialSecurity.gov
2. Call Social Security by phone at 1-800-772-1213, from 7 a.m. to 7 p.m. Monday through Friday
3. Go in person to your local Social Security office

Find More Dental Medicare Resources

If you’re looking for dental insurance and wondering whether Medicare covers dental implants, the simple answer is no. Some Medicare Advantage policies may cover dental implants, but these comprehensive coverages are more expensive and are usually capped at an annual limit around $1,500. Click here for more information on Medicare dental plans.

Frequently Asked Questions