Key Takeaways
- Original Medicare doesn’t cover most dental services, unless they’re tied to another covered procedure. Some Medicare Advantage (MA) plans include dental benefits.
- The American Dental Association (ADA) says MA dental coverage is often limited, confusing, and inconsistent. In a letter to Congress, it called for reforms to expand seniors’ access to care.
- To avoid unexpected costs, you should ask about provider networks, what’s covered, annual maximums, waiting periods, and out-of-pocket expenses before enrolling.
- Alternatives to MA dental benefits include standalone dental insurance, discount programs, or bundled dental, vision, and hearing plans that may provide broader coverage.
What the ADA Says About Medicare Advantage Dental Benefits
Many Medicare Advantage (MA) plans advertise dental coverage, but the benefits vary widely. In a July 2025 letter to Congress, the American Dental Association (ADA) raised concerns about these MA dental benefits, including:
- Complexity and confusion: Seniors face dozens of plan choices that can be overwhelming.
- Lack of transparency: Plans often omit key details that seniors need to make informed decisions, such as annual maximums and covered services.
- Coverage variability: Some markets offer robust benefits, but others provide only basic care.
Fast Fact
An annual maximum is the most your dental plan will pay for covered care in a year. You’re responsible for all costs after you reach the maximum, usually until your annual maximum resets at the start of the calendar year.
“Despite living in highly concentrated markets, MA beneficiaries choose from an average of forty-three plans, even though only a few insurers are offering coverage,” the ADA wrote in its letter. “Adding to the confusion, plan marketing materials often omit key details such as annual maximums, cost-sharing, and which services (if any) are covered beyond diagnostics and preventive care. Such variability and lack of standards make it difficult for seniors to compare options, create confusion, and limits the utility of the benefits.”
Does Medicare Cover Dental?
It depends. Original Medicare typically doesn’t cover routine dental care, including cleanings, fillings, extractions, or dentures. It also doesn’t provide an option to add separate dental insurance that you can add to your health plan.
Many seniors turn to Medicare Advantage (MA) plans from private insurers to fill the dental coverage gap. MA plans are Medicare-approved plans that can include extra benefits, such as dental, that Original Medicare lacks.
Key Questions to Ask Before Choosing a Medicare Plan With Dental Benefits
The ADA has urged lawmakers to require clearer, standardized dental benefit summaries and better access to care, but reforms may take time. In the meantime, ask these questions when comparing plans to understand your coverage and costs.
- Does your dentist accept the plan? Don’t assume that your current dentist is in-network; verify it with your insurer and your dentist.
- What’s the plan’s coverage scope? Are minor dental procedures like fillings covered? What about major ones like crowns, root canals, and implants?
- What’s the most the insurer will pay per year for dental care? Some plans have annual maximums as low as $500, while others have higher caps.
- Are there waiting periods for major procedures? Plans that cover major procedures typically require you to wait a certain number of months before your plan’s coverage kicks in.
- What are the out-of-pocket costs? Check copays, coinsurance, and deductibles.
How to Shop for Dental Coverage
Finding a dental plan that meets your needs may be difficult, but it can pay off in the long run, DentalInsurance.com President Avery Smith said in a recent press release.
“Seniors value good dental insurance,” he said. “Our own data finds that seniors keep their dental plan three to four times longer than our younger customers.”
Since you may keep a plan for years, shop carefully. Here’s how to compare your options and find a plan that suits your needs and budget.
Medicare Advantage Plan Comparison
You can compare MA plans using:
Standalone Dental Insurance
Standalone dental insurance is a policy separate from your Medicare coverage. It’s similar to a traditional health insurance policy—there are monthly premiums, deductibles, and an annual maximum. Some may cover up to $3,000 to $5,000 annually in eligible dental expenses.
Discount Dental Programs
These plans aren’t insurance. Instead, they’re more like a membership that you pay a fee for in exchange for discounted rates at participating dentists. The programs have more limited benefits than standalone dental policies, but may not have waiting periods or annual maximums.
Other Options
Other options worth looking into include:
- Dental, vision, and hearing (DVH) plans: This supplemental insurance policy typically doesn’t have waiting periods for preventative services or require you to use a dentist within a network.
- Employer-sponsored dental coverage: If your spouse is still working, you might be able to continue with their company’s dental plan, even if you aren’t on the medical insurance plan.