Does Medicare Cover Wisdom Teeth?

Wisdom teeth usually emerge during our late teens or early adult years. Extracting wisdom teeth may be necessary when there is not enough room for them to erupt properly. Improper eruption of a third wisdom tooth may lead to an infection or impacted tooth. Most of the time, wisdom teeth are removed before they even erupt to prevent this.

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

Does Medicare Cover Wisdom Teeth?

The short answer is no. In most cases, Medicare will not cover the cost of a wisdom tooth extraction. 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 wisdom tooth extraction.

Original Medicare

Original Medicare (Medicare Part A and Part B) does not provide coverage for wisdom teeth extraction. So you will have to pay for 100 percent of the costs of your wisdom tooth extraction if you are enrolled in Original Medicare. That is because Original Medicare considers tooth extraction in general as a routine dental and nonemergency procedure.

Original Medicare does not consider a wisdom tooth extraction as a medically necessary procedure. However, in some cases, 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

However, it is very rare that Medicare Part A will provide coverage for wisdom tooth extraction.

Part C Coverage for Wisdom Teeth Extraction

However, some Medicare Advantage plans (Medicare Part C) provide coverage for wisdom teeth extraction. Medicare Advantage plans cover everything Original Medicare covers as well as some additional benefits. However, exactly what it covers and what your out-of-pocket costs are will vary depending on the specifics of your plan.

There are quite a few Medicare Part C plans that provide coverage for dental care. And those Medicare Part C plans may provide coverage for wisdom tooth extraction.

How Much Does A Wisdom Teeth Extraction Cost?

Wisdom tooth extraction can be expensive, especially without health insurance to provide coverage for the costs. A simple extraction may cost from $75 to $200 per tooth or $300 to $1,000 if all four wisdom teeth are to be extracted.

There are also two kinds of surgical extractions: soft tissue impaction and bony impaction. Soft tissue impaction may cost from $225 to $600 per tooth and $800 to $1,800 for all four 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 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.