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Dentures are prosthetic devices that can help in replacing missing teeth. Not only can they boost a person’s self-esteem, but they can also relieve pain and help a person with eating food and maintaining a good diet. While Original Medicare does not usually provide coverage for routine dental services, is having dentures an exception to that rule?
So a common question many people have is, “does Medicare cover dentures?” In this article, we answer that question in clear, plain English. You will also find the average costs of dentures and other helpful info.
Does Medicare Cover Dentures?
The short answer is no. In most cases, Medicare will not cover the cost of dentures. That said, there may be some situations where you can get these costs covered. Below we’ll take a closer look at this to see when you might be able to get Medicare to pay for your dentures.
Part C Coverage for Dentures
Some Medicare Advantage plans (Medicare Part C) do provide coverage for dentures. Medicare Advantage plans cover everything Original Medicare covers but often include some additional benefits. However, exactly what they cover and what your out-of-pocket costs are will vary depending on the specifics of your plan.
Many Medicare Part C plans provide coverage for dental care. If your Medicare Part C plan has dental care coverage, you will need to visit a dentist that is within the plan’s network for your Medicare Part C plan to provide coverage for your tooth extraction or other dental services.
Original Medicare
Original Medicare (Medicare Part A and Part B) does not provide coverage for dentures. Most of the time, Original Medicare does not provide coverage for routine dental services such as dentures. However, Original Medicare may provide coverage for some dental services including dentures if it is considered medically necessary.
Original Medicare does not provide coverage for the following dental services. Especially if they are not medically necessary and are only for your dental health:
- Routine dental checkups
- Cleanings
- Fillings
- Dentures
- Tooth extraction
But, if your dental service is a part of your treatment for your overall health, Original Medicare may provide coverage. These are some situations where Original Medicare may provide coverage for your dental care:
- An oral examination performed in a hospital before undergoing a kidney transplant
- An oral examination performed in a rural clinic or Federally Qualified Health Center undergoing a heart valve replacement
- Any medically necessary dental services for your radiation treatment for certain jaw-related diseases
- A ridge reconstruction after a facial tumor is removed
- Surgery to treat fractures of the jaw or face
- Dental splints and wiring after jaw surgery
Medicare Part A may provide coverage for certain dental services if you require emergency dental care while you are admitted as an inpatient in a hospital.
How Much Do Dentures Cost?
A full set of dentures can cost anywhere from $600 to $8,000 depending on the material and type of dentures. The average cost is around $1800. Additional costs may come from tooth extractions or later adjustments to the dentures.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, you can check out other articles in this series including: Does Medicare cover electric wheelchairs?
