Although Original Medicare does not provide coverage for most dental procedures, in critical cases, it will. Given a medically necessary reason, Medicare might provide coverage for some dental procedures.
This brings up a common question many people have, which is, “does Medicare cover wisdom teeth removal?”
In this article, we answer that question in clear, plain English. You will also find the average costs of wisdom teeth removal and other helpful information.
Does Medicare Cover Wisdom Teeth Removal?
The short answer is no. In most cases, Medicare will not cover the cost of wisdom teeth removal, even in a hospital.
That being 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 inpatient wisdom teeth removal.
Original Medicare Coverage of Wisdom Teeth Removal
Original Medicare (Medicare Part A and Part B) does not usually provide coverage for inpatient wisdom teeth removal.
You will most likely have to pay 100 percent for your inpatient wisdom teeth removal.
This plan does not necessarily provide coverage for many treatments and services, including inpatient wisdom teeth removal and other dental-related procedures.
When Services May be Covered, and Which Plan?
Coverage for inpatient services, such as hospital services, is provided by Medicare Part A. Most of the time, Medicare Part A does not provide coverage for inpatient wisdom teeth removal.
However, in some cases, Medicare Part A may provide inpatient wisdom teeth removal coverage. Medicare Part A may provide coverage for wisdom tooth extraction or some other routine dental procedure if it is part of:
- An emergency oral surgery
- Certain complicated dental procedures
- Dental care prior to or as part of a medically necessary procedure
Coverage for wisdom teeth removal would be provided by Medicare Part A, were it to take place in an inpatient setting, like a hospital.
Medicare Advantage Coverage of Wisdom Teeth Removal
Some Medicare Advantage plans (Medicare Part C) provide inpatient wisdom teeth removal coverage.
Advantage plans cover everything Original Medicare covers but provide extra benefits that Original Medicare does not. Some dental services are one of the more common extra benefits Part C plans provide.
However, all Part C plans differ in their coverage and out-of-pocket costs, so you’ll want to check with your plan for specific coverage details related to wisdom teeth.
How Much Does A Wisdom Tooth Extraction Cost?
A simple extraction may cost $75 to $200 per tooth and $300 to $1,000 if all four wisdom teeth are extracted.
On the other hand, soft tissue impaction may cost from $225 to $600 per tooth and $800 to $1,800 for the extraction of all wisdom teeth.
Bony impaction may cost from $250 to $500 for one wisdom tooth and $1,000 to $2,300 for all four wisdom teeth.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage. Always 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: