Does Medicare Cover Dental Extractions?
Original Medicare (Parts A & Part B) typically does not cover dental extractions unless it is required to perform a different Medicare-covered procedure. Other options, such as Medicare Advantage and private dental insurance, are more likely to offer coverage for comprehensive dental care.
Do Medicare Parts A & B Cover Dental Extractions?
Medicare Parts A & B do not cover dental extractions under normal circumstances, though there are a few medical exceptions.
While Medicare services cover a wide range of outpatient treatments and procedures, it has never covered dental services. However, should your dental condition require you to be hospitalized, then Part A will likely offer coverage for inpatient care. If the procedure was medically necessary in an outpatient clinic, then Part B may help cover these costs.
There are other coverage options if you don’t think Original Medicare will cover your dental extraction. Medicare Advantage, Medicaid, private dental insurance or community health clinics are other options to help lower your costs.
Medicare will provide coverage for a dental extraction if the tooth was extracted in order to perform a different Medicare-covered procedure. This means, the dental extraction was medically necessary for another service.
The U.S. Centers for Medicare & Medicaid Services requires you to meet specific exceptions for dental extraction coverage.
- Reconstruction of your jaw
- For preparation for radiation treatment
- If you have neoplastic diseases in your jaw
Other dental service exceptions under Original Medicare coverage include oral exams in preparation for a kidney or heart valve replacement and facial reconstruction.
Does Medicare Advantage Cover Dental Extractions?
Most Medicare Advantage plans will cover dental extractions. In 2021, the Kaiser Family Foundation found that 86% of Medicare Advantage beneficiaries have access to preventative and extensive dental benefits, which includes dental extractions.
- Dental extractions
- Crowns and bridges
- Root canals
- Dental implants
- Dental exams
- Routine cleaning
Preventive services, like routine cleaning, are usually covered under Medicare Advantage plans, but a dental extraction may require cost-sharing. Typically, 80% of a dental extraction procedure is covered but each plan varies in coverage.
Other Options for Dental Extraction Coverage
Private dental insurance and Medicaid are other options for dental extraction coverage. However, since these options aren’t under Medicare, you will be faced with managing multiple plans and premiums.
Most private dental insurance plans cost between $20 to $60 per month, depending on where you live and what plan you choose. These monthly premiums are in addition to your Medicare premiums, and there could be deductibles and coinsurance costs as well. Since a dental extraction isn’t a preventive service, there is likely a coinsurance charge if you choose this route.
Medicaid coverage and costs are determined by state. Most states offer coverage for emergency dental procedures for adults, but less than half the states offer comprehensive dental care, which includes dental extractions. The Center for Health Care Strategies offers a chart that clarifies each state’s coverage, costs and restrictions.
Cost of Dental Extractions Without Insurance
Dental extractions can cost up to $600 per tooth without insurance at a standard dentist office. This price will fluctuate depending on if your tooth is impacted, the complexity of the removal and which tooth is being extracted.
There are other more affordable options to get your teeth extracted without insurance, such as dental schools, community health clinics and the dental lifeline network. Each option has resources to help you find affordable dental care in your area.
At a community health clinic, a dental extraction typically costs around $125.
Dental extraction at a dental school typically costs 25% to 50% less than a standard dentist office. But the price will vary depending on how complicated the tooth removal is.
If you qualify for a dental lifeline network tooth extraction, your procedure could be free, but there is an application and a waiting list to be approved. If you have Medicaid dental coverage, you must use Medicaid coverage before applying to the dental lifeline network.
12 Cited Research Articles
- United HealthCare Services. (2022, April 12). Dental Coverage with Medicare Advantage. Retrieved from https://www.aarpmedicareplans.com/shop/medicare-advantage-plans/ma-dental-benefits.html
- U.S. Centers for Medicare % Medicaid Services. (2021, December 1). Medicare Dental Coverage. Retrieved from https://www.cms.gov/Medicare/Coverage/MedicareDentalCoverage
- Freed, M. et al. (2021, September 21). Dental, Hearing, and Vision Costs and Coverage Among Medicare Beneficiaries in Traditional Medicare and Medicare Advantage. Retrieved from https://www.kff.org/health-costs/issue-brief/dental-hearing-and-vision-costs-and-coverage-among-medicare-beneficiaries-in-traditional-medicare-and-medicare-advantage/
- Center for Health Care Strategies Inc. (2019, September) Medicaid Adult Dental Benefits Coverage by State. Retrieved from https://www.chcs.org/media/Medicaid-Adult-Dental-Benefits-Overview-Appendix_091519.pdf
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Dental Care. Retrieved from https://www.medicaid.gov/medicaid/benefits/dental-care/index.html
- Member Benefits. (n.d.). Dental Costs With And Without Insurance. Retrieved from https://memberbenefits.com/dental-costs-with-and-without-insurance/#:~:text=Average%20tooth%20removals%20cost%3A,tissue%20and%20complicated%20surgical%20extractions
- U.S. Department of Health & Human Services. (n.d.). Find A Health Center. Retrieved from https://findahealthcenter.hrsa.gov/
- Dental Lifeline Network. (n.d.). State Programs. Retrieved from https://dentallifeline.org/our-state-programs/
- Florida Dental Centers. (n.d.) Fee Schedule. Retrieved from https://www.floridadentalcenters.com/costs/
- Tufts University. (n.d.). Price Comparison Guide. Retrieved from https://dental.tufts.edu/patient-care/general-dentistry/price-comparison-guide
- Dental Life Network. (n.d.). DDS Application. Retrieved from https://dentallifeline.org/donated-dental-services-dds-application/
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Dental Services. Retrieved from https://www.medicare.gov/coverage/dental-services