Finding a Dentist Who Takes Medicare
Original Medicare and Medicare Advantage cover dental care differently. Online tools and understanding coverage can make finding a dentist who takes Medicare easier. If you can’t find a dentist who takes Medicare nearby, there are other options to reduce costs.
- Written by Lindsey Crossmier
Lindsey Crossmier is an accomplished writer with experience working for The Florida Review and Bookstar PR. As a financial writer, she covers Medicare, life insurance and dental insurance topics for RetireGuide. Research-based data drives her work.Read More
- Edited BySavannah Pittle
Senior Financial Editor
Savannah Pittle is a professional writer and content editor with over 16 years of professional experience across multiple industries. She has ghostwritten for entrepreneurs and industry leaders and been published in mediums such as The Huffington Post, Southern Living and Interior Appeal Magazine.Read More
- Reviewed ByAflak Chowdhury
Aflak Chowdhury is a Medicare expert and independent insurance broker specializing in group health insurance. He has worked for major providers including Humana and Principal Financial Group and today works mainly in the small group market.Read More
- Published: May 3, 2022
- Updated: October 20, 2023
- 4 min read time
- This page features 3 Cited Research Articles
- Edited By
- Original Medicare does not cover routine dental services but may cover emergency or complicated dental care requiring hospitalization.
- Medicare Advantage typically covers routine dental care limited to dentists within the plan’s network.
- You may find other options to help pay for dental care if Medicare doesn’t cover the dental services you need.
How Can I Find a Dentist Who Takes Medicare?
Finding a dentist who takes Medicare can be difficult or easy, depending on which part of Medicare you are covered by. Understanding Medicare’s dental coverage under Parts A, B and C will help you navigate lowering your dental costs.
According to the U.S. Centers for Medicare & Medicaid Services (CMS), Medicare Parts A & B, also known as Original Medicare, typically cover little to no dental services. If you have Original Medicare, finding a dentist who will cover your dental treatment could be difficult. However, there are specific instances where coverage is guaranteed.
If you have Medicare Part C, also known as Medicare Advantage, most dental services are covered. However, each plan varies, so it’s best to confirm out-of-pocket costs before trying to undergo a procedure.
You could also go directly to your insurance provider’s website if you have a Medicare Advantage plan to check for dental coverage details. For example, Aetna has a link to find in-network dentists.
Be sure to look up reviews for each dentist before committing to a procedure. This will help you avoid malpractice or being overcharged.
Before enrolling in a private dental plan, you should ask about any pre-existing conditions limitations and if there is a waiting period for certain conditions.
Medicare Dental Coverage Under Parts A or B
If you have Original Medicare, then you are only qualified for specific dental services with an emergency dentist or oral surgeon. This is because Original Medicare will only cover a dental service if the dental procedure is medically necessary or if you need dental work done in order to perform a different Medicare-approved procedure.
CMS has explicit scenarios for coverage with an emergency dentist or oral surgeon.
- Reconstruction of your jaw after an injury.
- Dental extractions in preparation for radiation treatment or neoplastic diseases in your jaw.
- Oral examinations before a kidney transplant or heart valve replacement.
Medicare Advantage Dental Coverage Options
Your insurance provider may offer a finder tool on their website to help you locate a dentist who accepts your Medicare Advantage plan. In-network dentists will always offer better coverage than out-of-network.
Although coverage for dental services vary by plan, most Medicare Advantage plans cover 100% of preventive care, such as routine cleanings and x-rays. Extensive dental procedures, like dental implants, typically require cost sharing or coinsurance.
According to the National Center for Health Statistics, you’re most likely to receive dental coverage if you live in the North Central, Middle Atlantic and New England regions of America.
Some of the major companies that offer Medicare Advantage plans with dental coverage include Cigna, Humana, Aetna and United Healthcare.
Humana and United Healthcare offer Medicare Advantage plans in all 50 states, making it easier to find a dentist in your area.
Even if you believe you’ve found a dentist who takes Medicare, always call to confirm instead of solely relying on the internet’s information.
Other Options If You Can’t Find a Dentist Who Takes Medicare
If you cannot find a dentist who takes Medicare, there are still other options.
If you need immediate dental care, you can go to a dental school or a local health center near you. Both options will give you low-cost dental care without requiring Medicare coverage.
If you have time to wait before getting dental work done, you can enroll in private dental insurance or Medicaid. If you choose either of these options, which are not a part of Medicare, you will be managing multiple plans and premiums at once.
FAQs: Finding a Dentist Who Takes Medicare
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3 Cited Research Articles
- U.S. Centers for Medicare & Medicaid Services. (2022). Dental Services. Retrieved from https://www.medicare.gov/coverage/dental-services
- U.S. Centers for Medicare & Medicaid Services. (2021, December 1). Medicare Dental Coverage. Retrieved from https://www.cms.gov/Medicare/Coverage/MedicareDentalCoverage
- Centers for Disease Control and Prevention. (2019, May). Regional Variation in Private Dental Coverage and Care Among Dentate Adults Aged 18–64 in the United States, 2014–2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db336.htm
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