Does Medicare Cover Root Canals?

The dental pulp is the soft substance in the center of the tooth. In it are the nerve, blood vessels, and connective tissue. When dental pulp is infected, inflamed, or dead, it needs treatment. That treatment is known as a root canal.

So a common question many people have is, “does Medicare cover root canals?” In this article, we answer that question in clear, plain English. You will also find the average costs of root canals and other helpful info.

Does Medicare Cover Root Canals?

The short answer is no. In most cases, Medicare will not cover the cost of root canals. 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 root canals.

Original Medicare

Original Medicare (Medicare Part A and Part B) does not provide coverage for the root canals. That is because Original Medicare does not provide coverage for routine dental services and care.

Original Medicare only provides coverage for dental services if it is part of a medically necessary treatment, which includes some oral surgeries that you may need prior to medically necessary treatment. However, Original Medicare will not provide coverage for dental services such as root canals on a regular basis.

Part C Coverage for Root Canals

However, some Medicare Advantage plans (Medicare Part C) provide coverage for root canals. Medicare Advantage plans cover everything Original Medicare covers and some additional benefits. However, coverage and out-of-pocket costs will vary depending on the specifics of your plan.

There are many Medicare Part C plans that provide coverage for dental services which include root canals. There are also many Medicare Part C plans that provide coverage for prescription medications. These Medicare Part C plans may provide coverage for medications that you may need after your root canal.

How Much Does A Root Canal Cost?

A root canal may cost somewhere from $300 to $1,000 for a single-rooted tooth, whether it is a canine or an incisor, and $500 to $1,400 for multi-rooted teeth, which can either be a premolar or a molar. One of the things that may affect the cost of a root canal is if it is treated by a general dentist or an endodontist.

What Are Tooth Symptoms That May Make You Eligible For A Root Canal?

Pain or toothache
Abscess or infection on the tooth
Trauma
Fracture
Resorption
Repeated dental procedures

Is A Root Canal A Painful Procedure?

Most of the time, people who undergo a root canal say that the procedure is not that painful. The tooth hurts more if it is not treated and the root canal can help in relieving that pain.

However, once the anesthesia wears off after the procedure, the gums around the treated tooth will be sore from the rubber dam clamp, especially if you undergo a root canal due to an infection.

Recovering after a root canal is usually quick and you can easily return to normal activities after. However, it is advised not to chew using the treated tooth to avoid pain.

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.