Medicare is health care coverage through the U.S. government. People 65 or older who paid Medicare taxes for at least 10 years are eligible. If you are younger than 65 but have a disability, or if you have reached the end stage of renal disease, you might be eligible. However, Medicare does not cover all necessary dental care.

History

Dental care was excluded in the first Medicare program. The program was amended in 1980 to make an exception for in-hospital dental services.

Coverage

If dental services are a necessary part of some in-hospital treatment that Medicare covers, that dental service might be covered.

Exclusions

However, in-hospital dental services are not covered unless directly connected to in-hospital services that are covered. Even if there is a need for dental care or in-hospital dental services involving teeth or supporting structures, those services will not be covered. If dentures are needed because a procedure covered by Medicare resulted in the loss of teeth, for example, Medicare will not cover the cost of the dentures.

Definition

Supporting structures include the gums that support the teeth and the ridge that holds the tooth sockets.

Exceptions

Specific exceptions to exclusions, as stated by the Center for Medicare and Medicaid Services: "The extraction of teeth to prepare the jaw for radiation treatment of neoplastic disease" and "An oral or dental examination performed on an inpatient basis as part of comprehensive workup prior to renal transplant surgery or performed in a RHC/FQHC prior to a heart valve replacement."

Source:

CMS: Medical Dental Coverage

More Information:

HHS.gov: FAQ