Does Medicare Cover Dental? Original Medicare vs Advantage Dental in 2027

Does Medicare cover dental care? For most people, no. Original Medicare, Part A and Part B, does not pay for routine cleanings, fillings, tooth extractions, dentures or implants. You pay the full bill for that care yourself.

There are real exceptions, though. Medicare pays for some work on your teeth that is tied to a covered medical treatment, such as an organ transplant, heart valve surgery, cancer treatment or kidney dialysis.

This guide explains those exceptions, what Medicare Advantage dental plans really include, what changes for 2027, and where to find low-cost care if Medicare will not pay. Every rule comes from Medicare.gov or the CMS dental services page.

Key Takeaways

• Original Medicare does not cover routine dental care. Cleanings, fillings, extractions, dentures and implants are all on you, and the law (Social Security Act section 1862(a)(12)) is the reason.
• Medicare does pay for care that is closely linked to certain covered treatments: organ, stem cell or bone marrow transplants, heart valve replacement, some cancer treatments and dialysis for end-stage renal disease.
• No change to Original Medicare dental coverage is proposed for 2027. The last new exception, for dialysis patients, was added in the 2025 rule.
• Most Medicare Advantage plans include some dental coverage, but many cover preventive care only, cap what they pay each year and use a network.
• If you have no dental coverage, check Medicaid if your income is low, community health centers, dental schools, PACE and the VA.

Does Medicare cover dental? The short answer

No, not in most cases. Medicare.gov says Medicare “doesn’t cover dental services like routine cleanings, fillings, tooth extractions (removals), or items like dentures and implants.” You pay all costs for that care.

Medicare only pays for services that are directly linked to certain covered medical treatments, or for the hospital stay when a procedure on your teeth has to be done in a hospital.

This exclusion is written into federal law, not just Medicare policy. CMS explains that under Section 1862(a)(12) of the Social Security Act and the rule at 42 CFR 411.15(i), Medicare does not pay for care, treatment, filling, removal or replacement of teeth, or the structures that directly support the teeth.

That is why a yearly checkup with your dentist is not covered, even though a yearly wellness visit with your doctor is. It also explains why Medigap plans, which only fill gaps in what Original Medicare covers, generally leave it out too.

Many people expect their coverage to look like a job-based plan with separate dental insurance. Medicare was never built that way.

If you want routine care for your teeth paid for after you turn 65, you need a separate source of coverage: a Medicare Advantage plan with dental benefits, a stand-alone dental plan, Medicaid, or one of the low-cost options later in this guide.

What dental care does Original Medicare cover?

Original Medicare covers dental services that are “inextricably linked” to a covered medical treatment, meaning the medical treatment is less likely to work without it. Medicare.gov’s examples include an oral exam and treatment before a heart valve replacement or a transplant.

The full list on Medicare.gov and the CMS dental page includes these situations:

• Transplants: an oral exam and dental treatment before an organ transplant, including a stem cell or bone marrow transplant.
• Heart valve surgery: an exam and treatment before a heart valve replacement or a valvuloplasty procedure.
• Cancer treatment: care such as an extraction to treat a mouth infection before chemotherapy, CAR T-cell therapy or high-dose bone-modifying drugs used to treat cancer.
• Head and neck cancer: treatment for a dental or mouth complication you develop during head and neck cancer treatment.
• Kidney dialysis: dental or oral exams before and during Medicare-covered dialysis if you have End-Stage Renal Disease (ESRD), plus treatment to clear a mouth infection.

CMS also lists a few older, narrower cases. Medicare can pay for rebuilding the jaw ridge at the same time as surgery to remove a tumor, for stabilizing teeth while a broken jaw is repaired, and for dental splints used to treat a covered medical condition such as a dislocated jaw joint.

When that care is covered, Part A or Part B can also pay for the things that go with it, such as anesthesia, diagnostic X-rays and use of an operating room. These services can happen in a hospital or in a dentist’s office.

Each case has the same logic. The goal is to protect a serious medical treatment, not to keep your teeth healthy in general. A tooth infection before a transplant or heart surgery can put the patient at risk, so Medicare treats clearing it as part of the medical care.

What Medicare still will not pay for

Even inside these rules, CMS lists clear limits. Routine dental care is out. So is pulling an impacted tooth, and so is work to prepare your mouth for dentures, such as reshaping the jawbone or the gums.

The exception also does not stretch to general health problems that better oral health might help with.

In the 2025 rule, CMS asked for public comments on dental care for people with diabetes, autoimmune diseases, sickle cell disease and hemophilia, but it did not add any of them. Those conditions are still not covered reasons.

How Medicare’s dental exceptions grew from 2023 to 2027

Medicare added its dental exceptions through physician fee schedule rules. The 2023 rule covered transplants and heart valve procedures and set up head and neck cancer care from 2024. The 2024 rule added cancer complications, chemotherapy, CAR T-cell therapy and bone-modifying drugs. The 2025 rule added dialysis.

The 2026 rule added nothing, and the 2027 proposed rule has no changes on this topic.

Rule year	What CMS added	Status
Before 2023	Jaw reconstruction after injury, extractions before radiation for cancer of the jaw, oral exams before a kidney transplant	Long-standing
2023	Exams and treatment before organ transplants (including stem cell and bone marrow), heart valve replacement and valvuloplasty; head and neck cancer exams starting in 2024	Final
2024	Head and neck cancer complications; chemotherapy, CAR T-cell therapy and high-dose bone-modifying drugs for cancer	Final
2025	Exams and infection treatment before or during dialysis for End-Stage Renal Disease	Final
2026	No new dental situations	Final
2027	No dental section in the proposed rule (final rule expected in early November 2026)	Proposed

Sources: CMS fact sheets on the 2023, 2024 and 2025 final rules, and the 2026 final rule in the Federal Register.

For the 2026 rule, CMS wrote that it “did not make any proposals” based on the public submissions it got, most of which asked about people with diabetes. It said it will consider them in the future. So any further expansion would have to come in a later rule.

Medicare dental coverage in 2027: what changes

For Original Medicare, no change is proposed for 2027. The proposed 2027 physician fee schedule rule has no section on dental coverage, and Medicare’s 2027 “What’s New” guide does not mention teeth at all.

The Medicare & You 2027 handbook lists four kinds of exceptions: heart valve repair or replacement, organ transplants, cancer-related treatments and dialysis for ESRD.

The 2027 changes that matter here come from the Medicare Advantage side. In its final rule for 2027, issued April 2, 2026, CMS set new limits on the debit cards some plans give members to spend on extra benefits.

Those cards must now be electronically linked to items and services the plan covers, and they are limited to the plan year. If your plan loads a card that you have used for these costs, check your 2027 plan papers, because unused money will not roll over.

The same rule also dropped the requirement for plans to send a mid-year notice about extra benefits you have not used. That letter listed extra benefits you had not used yet. From 2027, you will need to track your own unused benefits.

CMS expects extra benefits overall to hold steady. Its September 28, 2026 release on 2027 plans said that hearing, dental and vision benefits “are expected to remain stable.” Compare plans during Medicare Open Enrollment, October 15 to December 7, 2026, for coverage that starts January 1, 2027.

Do Medicare Advantage plans cover dental?

Most do, but coverage varies a lot. A June 2026 KFF analysis found that 98% of people in individual Medicare Advantage plans have some dental benefit, and 93% of people in Special Needs Plans do.

That count includes plans that only cover preventive care such as cleanings, so having “dental” does not mean fillings, crowns or dentures are covered.

KFF says these benefits can range from preventive care only to more complete coverage such as crowns or dentures. It also notes that many plans set a yearly dollar cap and some limit you to a network of dentists. Access to these extra benefits stayed stable from 2025 to 2026.

Prior authorization is part of the picture too. KFF found that most Medicare Advantage enrollees are in plans that require prior approval for some extra benefits, including preventive dental services. Call the plan before a big job so you know what it will approve.

How much Medicare Advantage dental plans pay

The most detailed numbers on dental caps come from KFF’s 2021 review, which is the newest analysis of plan dollar limits it has published. Treat these as a guide to how plans are built, not as current amounts.

• 78% of Medicare Advantage enrollees offered more than preventive dental care were in plans with a yearly dollar limit. The average limit was $1,300.
• 59% of those enrollees were in plans that paid $1,000 or less a year.
• The most common coinsurance for bigger work such as fillings, extractions and root canals was 50%.
• About 10% had to pay a separate premium to get any of this coverage.
• In KFF’s sample of plans covering dentures, each one limited dentures to one set every five years.

A cap of $1,000 to $1,300 can go quickly if you need major work such as crowns or root canals. If you know you need major work, compare the plan’s yearly maximum, its coinsurance for major services and its waiting periods, not just the word “dental” in the plan summary.

The 2027 handbook gives the same advice in plain terms: dental and other extra benefits in these plans “are generally limited, so check with the plan before you join.” For a full comparison of the two paths, see our guide to Medicare Advantage vs Medigap.

Does Medigap cover dental?

No. Medicare.gov says Medigap plans generally do not cover vision or dental care, hearing aids, glasses, long-term care or private-duty nursing. Medigap pays your share of costs for services Original Medicare covers. Because routine care is not a covered service, a Medigap plan has nothing to pay toward it.

Medigap can still help with the covered exceptions. If Medicare pays for work linked to your transplant or cancer care, your Medigap plan can pay some or all of the 20% coinsurance, as it would for any other Part B service. See Medigap Plan G vs Plan N for how those plans split costs.

People who choose Medigap often buy a separate dental insurance plan for routine care. That is one of the trade-offs to weigh against a plan with built-in dental benefits.

What you pay when Medicare covers dental care

For a covered dental service under Part B, you pay 20% of the Medicare-approved amount after you meet the Part B deductible, which is $283 in 2026. If you must be admitted to a hospital, Part A applies instead: you pay the Part A deductible of $1,736 in 2026, then $0 a day for the first 60 days.

For a longer hospital stay, Medicare.gov lists $434 a day for days 61 to 90 in 2026, and $868 a day for lifetime reserve days. The 2027 amounts have not been announced yet. CMS usually publishes them in the fall. Our guide to Medicare deductibles will show the new figures once they are out.

The hospital rule has a twist. Part A can pay for your hospital stay when your health or the size of the dental procedure means it must be done in a hospital. But the procedure itself is only covered if it also fits one of the linked-treatment exceptions above.

For everything outside the exceptions, CMS is direct: you pay all costs for services Medicare does not cover. A KFF study of 2018 spending found that beneficiaries who used dental care paid an average of $992 out of pocket in traditional Medicare and $766 in Medicare Advantage.

How to get Medicare to pay for dental care

Your doctor and your dentist must work together. CMS says that without care coordination between the two providers, Medicare will not pay. The dentist must also be enrolled in Medicare to bill for covered care, and since July 1, 2025 the claim must carry a code called the KX modifier.

Use these steps if you are facing a transplant, heart valve surgery, cancer treatment or dialysis:

1. Ask your doctor whether you need a dental exam or treatment before your procedure, and ask them to put it in writing.
2. Ask the dentist whether they are enrolled in Medicare, because only enrolled providers can bill Medicare for covered care.
3. Make sure the doctor and the dentist share records, so the claim shows the care is linked to your medical treatment.
4. Ask the dentist’s office to bill Medicare with the KX modifier and the right diagnosis code.
5. If Medicare denies the claim, read your Medicare Summary Notice and ask both offices to confirm the coordination was documented before you appeal.

CMS notes that it may pay for several visits if more than one is needed to clear an infection before a transplant. Keep copies of every note from both offices.

Medicaid and dental care for people with Medicare

If your income is low enough for Medicaid, it may cover the care Medicare will not. Medicaid.gov says states choose whether to provide adult dental benefits, and there are no minimum requirements. CMS says some states pay for routine and other dental services for people who have both Medicare and Medicaid.

Coverage differs widely. The National Institute of Dental and Craniofacial Research says most states offer only limited adult dental services, while some offer extensive ones. Our guide to adult Medicaid dental coverage by state shows what your state covers and how to find a dentist who accepts Medicaid.

Medicare Savings Programs are different. They help pay Medicare premiums and, for some people, Medicare deductibles and coinsurance. They do not add benefits for teeth, because they only pay costs for items and services Medicare covers. Read more in our Medicare Savings Programs guide.

Low-cost dental care if Medicare will not pay

If you have no dental coverage, start with a community health center, a dental school clinic or, if you qualify, PACE or VA dental care. Health centers funded by HRSA treat dental needs and adjust their fees based on income and family size. Dental school clinics offer reduced-cost care supervised by licensed dentists.

Community health centers

HRSA funds about 1,400 health centers that run more than 16,600 service sites, and they served more than 32.7 million people in 2025.

They treat medical, dental, mental health and other needs, and they serve everyone, even people who cannot pay. Search by ZIP code with HRSA’s Find a Health Center tool and ask whether the site has a dental clinic.

Dental school clinics

NIDCR says dental schools often run clinics that give care at a reduced cost, with experienced, licensed dentists closely supervising the students. Ask the clinic about wait times and fees before you book.

NIDCR also warns about a scam. It does not offer dental implants, run implant trials or give money for treatment, and ads that claim otherwise are likely fraudulent. If you see one, check our Scam Watch page.

PACE

The Program of All-Inclusive Care for the Elderly (PACE) lists dentistry among the services it may cover. You must be at least 55, live in a PACE service area, need a nursing home level of care and be able to live safely in the community. You pay no deductible or copayment for care your PACE team approves.

VA dental care for veterans

VA dental benefits depend on your eligibility class. Veterans with a 100% service-connected disability rating or who are paid at the 100% rate for unemployability, among other classes, can get any needed dental care. You must enroll in VA health care before you can use a VA dental clinic.

Veterans and families who do not qualify for free care may be able to buy reduced-cost insurance through the VA Dental Insurance Program (VADIP), which is open to people signed up for VA health care or for CHAMPVA.

How to choose dental coverage with Medicare

Pick based on the care you expect to need, not just the monthly premium. Here is a simple way to compare your options during Open Enrollment:

• Mostly cleanings and checkups: a Medicare Advantage plan with preventive dental may be enough. Check whether you need prior approval and which dentists are in the network.
• Major work coming up: compare each plan’s yearly maximum and its coinsurance for crowns, root canals and dentures. A cap near $1,000 may not go far for major work.
• Original Medicare with Medigap: you will need separate dental insurance or a discount plan for routine care.
• Low income: apply for Medicaid and Medicare Savings Programs, then check your state’s adult dental benefit.

If you are also weighing hearing and vision, the same pattern applies. Read does Medicare cover hearing aids to see how those extra benefits work in Medicare Advantage.

Next steps

• Have a transplant, heart valve surgery, cancer treatment or dialysis coming up? Ask your doctor and a Medicare-enrolled dentist to coordinate your dental care before the procedure.
• During Open Enrollment, October 15 to December 7, 2026, compare the limits in each plan you are considering, not just whether dental is included.
• If money is tight, apply for Medicaid and look up a community health center with a dental clinic.
• Not sure which program fits? Start with our guide to Medicare vs Medicaid or our list of help for people with low income on Medicare.