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Does Medicare cover dentures?

En español  | No. Medicare doesn’t cover dentures or other dental devices, such as partial plates, nor does it cover routine dental care, such as dental exams, cleanings and X-rays.

It also doesn’t cover most dental procedures, such as extractions and root canals. The cost of dentures varies widely based on the material, type of dentures, where you need them and where you live.

Expect to pay $1,600 to $3,000 for either lower removable or upper removable dentures, the traditional false teeth that rest on top of the gums and are held in place with adhesive, according to Delta Dental’s cost estimator.

The price increases significantly and can be tens of thousands of dollars for more extensive procedures, such as implant-supported dentures. These dentures fit into tiny titanium posts inserted into your jawbone, preventing slippage and some of the bone loss associated with long-term denture use. They last longer than traditional dentures.

You’ll probably face additional fees for teeth extraction, at least for your first set of dentures.

Medicare doesn’t cover dentures, even though nearly 1 in 8 U.S. adults 65 and older report having no remaining teeth, according to a 2020 study from the federal Centers for Disease Control and Prevention (CDC). Why? Congressional lawmakers didn’t include it in the original Medicare and Medicaid Act of 1965 and have not expanded coverage for it since.

Yet even though Medicare passes on covering almost all things dental, you may be able to get some form of coverage for dentures or at least discounted rates from other sources.

Does Medicare Advantage cover dentures?

The good news is, yes. Most Medicare Advantage plans provide dental coverage. Some pay only for routine dental care while others allow for more extensive dental services, including the potential for dentures.

In 2021, 76 percent of people in Medicare Advantage plans that covered extensive dental services had coverage for periodontics or prosthodontics, according to a Kaiser Family Foundation study. Periodontics is the prevention and treatment of gum and tooth diseases. Prosthodontics is the branch of dentistry that specializes in making replacements for missing or damaged teeth, and that may include dentures, dental bridges, implants and other false teeth.

Typically, plans that cover dentures generally limit coverage to one set every five years. But cost sharing, meaning what you pay out of pocket and what insurance covers, varies widely. In 2021, plans that charged a fixed-dollar copayment ranged from $0 to $500, while plans that charged coinsurance, which is a percentage of the cost, typically charged members 50 percent to 70 percent of the cost for in-network providers.

Most plans put annual caps on extensive dental services, averaging $1,300 in 2021, but 8 percent of the plans had a coverage cap of $2,000 to $5,000. This cap usually didn’t apply to routine and preventive dental care.

Many Medicare Advantage plans include dental coverage automatically. But some plans charge extra for additional dental benefits, for example, $40 a month for $2,000 worth of extra dental benefits, including dentures.

With such a wide range of coverage levels, it’s important to research how each plan covers dentures.

Where can I find what Medicare Advantage covers?

You can find information about dental coverage for each Medicare Advantage plan in your area by using the  Medicare Plan Finder. Key in your zip code. In the  Plan Type  drop-down menu, click  ◯ Medicare Advantage  Plan | Apply.  

You then may be asked to choose your county if your zip code spans more than one. When you click Start, you’ll first have to note if you receive financial aid, then you’ll see an option to compare drug costs among plans. This doesn’t include dental costs. 

From there, you can link to a list of all Medicare Advantage plans in your area. A green check mark notes ✓ Dental  in the  Plan Benefits  list. You can narrow the list by clicking on Filter by: Plan Benefits | ☐ Dental coverage | Apply

For general information about the plan’s denture coverage, click  Plan Details  and scroll down to Extra Benefits. Look for the Prosthodontics section to find out whether the plan covers dentures and other dental prosthetics, including its in-network and out-of-network copays. You’ll see a note if you need prior approval and are subject to plan limits.

Note that the Plan Finder doesn’t include details about those limits or which types of prosthodontics are covered. For more information about your plan’s denture coverage, visit the plan’s website or contact the plan directly. You can find a link to plan websites in the Plan Finder and review plan documents directly on the site.

How else can I get help paying for dentures?

Other sources can help defray the costs of dentures:

  • Dental discount programs. Some programs charge an up-front annual fee in return for discounts on dental services, which can range from 30 percent to 40 percent off on cleanings, crowns, exams and fillings, and they may offer a 15 percent to 50 percent discount off the cost of dentures. These programs sometimes require you to use certain dentists.
     
  • Extra coverage from Medigap. Though standard Medigap policies exclude dental coverage, some Medigap insurers allow you to tack on dental coverage to your policy for an extra premium. This often entails membership in a dental discount program, such as certain types of dental coverage packaged with hearing and vision benefits too. 

  • Medicaid. Medicaid provides dental coverage for adults who meet income and asset requirements in some states. Medicaid covers full or partial dentures in more than half of the states.

  • Standalone dental insurance policies. Premiums, copayments, covered services and annual coverage maximums vary a lot from plan to plan. These may require you to use an in-network dentist and wait for a predetermined time before the plan will cover more expensive procedures. Some dental insurance plans cover dentures, typically with a copayment of about 50 percent.

  • Veterans benefits. The U.S. Department of Veterans Affairs provides dental care to veterans who qualify, and that can include dentures. The type and amount of dental care you can receive is based on your service-connected disability rating, your service history and other factors. Learn more on the VA’s dental care page.  

Keep in mind

You can withdraw money tax-free from a health savings account (HSA) to pay most out-of-pocket dental expenses. You can’t contribute to an HSA after you enroll in Medicare, but you can use money you’ve already saved in the account for eligible medical expenses at any age, including dentures and many dental expenses that insurance doesn’t cover.

Updated October 13, 2022

     

        


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