How Dental Insurance Works for People Over 65
What dental coverage looks like for seniors
Most seniors do not have dental insurance through Medicare. Original Medicare — the federal program that covers hospital and doctor visits — does not include routine dental care, cleanings, or dentures. This means you either pay out of pocket for dental work, buy a separate dental plan, or use a community health center that charges on a sliding scale based on income.
The dental plans available to you depend on where you live and what other insurance you have. If you are on Original Medicare, you can buy a standalone dental plan from a private insurer. If you are in a Medicare Advantage plan (also called Part C), some plans include dental coverage, though the scope varies widely — some cover only cleanings and exams, while others cover fillings or extractions too.
Dental work is expensive without coverage. A routine cleaning and exam might cost $100 to $200. A filling runs $150 to $300. A crown can cost $800 to $1,500 or more. Many seniors skip dental care because of cost, which can lead to infections, tooth loss, and problems eating or speaking.
Key Takeaways
- Original Medicare does not cover dental care, so you need a separate dental plan, Medicaid, or a Medicare Advantage plan that includes dental.
- Standalone dental plans for seniors often have waiting periods of 6 to 12 months before they cover major work like crowns or root canals.
- Medicare Advantage plans with dental coverage vary by plan and region — some cover only preventive care, while others cover fillings and extractions.
- Medicaid covers dental care in most states, but coverage and provider networks differ significantly by state.
- Community health centers and dental schools offer low-cost or sliding-scale dental care regardless of insurance status.
Original Medicare plus a standalone dental plan
If you are on Original Medicare (Part A and Part B), you can purchase a dental plan from a private insurance company. These plans are not part of Medicare — they are separate products you buy directly from the insurer or through a broker. Common insurers include Humana, Delta Dental, Cigna, and Aetna, though availability depends on your state and zip code.
Standalone dental plans typically fall into two categories: discount plans and insurance plans. A discount plan charges an annual or monthly fee (often $80 to $200 per year) and gives you a percentage discount at participating dentists — usually 10 to 60 percent off. You pay the dentist directly and submit for reimbursement, or the dentist bills the plan. An insurance plan works more like health insurance: you pay a monthly premium, a deductible (usually $50 to $150 per year), and then a copay or coinsurance for each service.
Most standalone plans have waiting periods before they cover major work. Preventive care — cleanings, exams, X-rays — is usually covered right away with no waiting period. Basic care like fillings may have a 6 to 12 month waiting period. Major work like crowns, root canals, or dentures often has a 12 month waiting period. Some plans exclude certain services entirely, such as cosmetic work or implants.
Annual maximums are common. Many plans cap what they will pay per year at $1,000 to $1,500. If you need expensive work, you may hit that cap quickly. Read the plan documents carefully to understand what is covered, what the waiting periods are, and what the annual maximum is.
Medicare Advantage plans with dental coverage
Medicare Advantage plans (Part C) are an alternative to Original Medicare. They are sold by private insurers and must cover everything Original Medicare covers, but many also include dental, vision, and hearing benefits that Original Medicare does not. About 70 percent of Medicare Advantage plans include some dental coverage, though the scope varies.
Some Medicare Advantage plans cover only preventive care: cleanings, exams, and X-rays. Others cover basic care like fillings and extractions. A smaller number cover major work like crowns or root canals. A few cover dentures or implants, though this is less common. The plan documents will specify what is covered and what you pay out of pocket.
The advantage of Medicare Advantage dental coverage is that there are usually no waiting periods — coverage starts when your plan does, typically January 1. The disadvantage is that you are locked into the plan's network of dentists, and if your current dentist is not in the network, you may have to switch. Also, Medicare Advantage plans change their benefits every year, so coverage you have this year may not be available next year.
If you are considering a Medicare Advantage plan partly for dental coverage, compare the plans available in your area carefully. Use the Medicare Plan Finder tool on Medicare.gov to see which plans include dental and what they cover. Call the plans directly to ask whether your dentist is in their network.
Medicaid coverage for seniors
Medicaid is a joint federal and state program that covers low-income people of any age, including seniors. Unlike Medicare, Medicaid does cover dental care in most states. However, coverage varies significantly by state — some states cover preventive care only, while others cover fillings, extractions, and dentures.
To be on Medicaid as a senior, your income and assets must fall below your state's limits. Income limits vary by state but are generally quite low — often around $1,000 to $1,500 per month for a single person. Some states also have asset limits, meaning you cannot own more than a certain amount in savings or property. A few states have eliminated asset limits for seniors, but most still have them.
If you are on both Medicare and Medicaid (called "dual may be able to access"), Medicaid covers services that Medicare does not, including dental care. If you are only on Medicaid, dental coverage depends on your state. Contact your state Medicaid office or visit your state's Medicaid website to learn what dental services are covered where you live.
Medicaid provider networks are often smaller than private insurance networks, and some dentists do not accept Medicaid because reimbursement rates are low. If you are on Medicaid, ask your dentist whether they accept it before scheduling an appointment.
Low-cost dental care options
If you do not have dental insurance and cannot afford private care, community health centers and dental schools offer care on a sliding scale or at reduced cost. A federally may have access to health center (FQHC) is a nonprofit clinic that receives federal funding and must serve anyone regardless of ability to pay. Most FQHCs have dental clinics. You pay based on your income — if you earn very little, care may be free or nearly free.
Dental schools train dentists and dental hygienists. Students perform the work under supervision of licensed instructors. Care is much cheaper than private practice — a cleaning might cost $20 to $50, and a filling might cost $50 to $100. The trade-off is that appointments take longer because students work slowly and carefully. To find a dental school near you, search "dental school" plus your city or state.
Some nonprofit organizations offer free or low-cost dental clinics on specific days. The National Association of Free & Charitable Clinics maintains a directory of clinics by state. Local senior centers, Area Agencies on Aging, and 211 (a helpline you can call or text) can also point you to low-cost dental care in your area.
Comparing your options: a side-by-side look
| Option | Who it is for | What it covers | Cost to you | Waiting periods |
|---|---|---|---|---|
| Standalone dental plan | Original Medicare beneficiaries | Preventive, basic, and major care (varies by plan) | Monthly premium + deductible + copay | 6 to 12 months for major work |
| Medicare Advantage with dental | Anyone may be able to access for Medicare | Preventive only, or preventive + basic, or preventive + basic + major (varies by plan) | Plan premium + copay (often $0 for preventive) | Usually none |
| Medicaid | Low-income seniors (income and asset limits apply) | Preventive and/or basic care (varies by state) | Usually free or very low copay | Usually none |
| Community health center | Anyone, regardless of insurance | Preventive and basic care | Sliding scale based on income | None |
| Dental school | Anyone, regardless of insurance | Preventive and basic care | Reduced fee (often $20–$100 per visit) | None |
How to find and compare plans in your area
If you are on Original Medicare and want to buy a standalone dental plan, start by visiting your state's health insurance marketplace or calling your state's insurance commissioner's office. They can tell you which plans are sold in your zip code. You can also call dental insurers directly — Delta Dental, Humana, Cigna, and Aetna all sell individual plans in most states.
If you are considering switching to a Medicare Advantage plan for dental coverage, use the Medicare Plan Finder at Medicare.gov. Enter your zip code and it will show you all plans available in your area, including which ones have dental coverage and what they cover. You can also call 1-800-MEDICARE to speak with someone who can walk you through the options.
Before you enroll in any plan, verify that your dentist is in the network (if the plan has a network). Call your dentist's office and ask. Also read the plan's summary of benefits to understand waiting periods, annual maximums, and what services require prior approval from the plan.
Frequently Asked Questions
Does Medicare cover dental cleanings?
No. Original Medicare does not cover any dental care, including cleanings and exams. You need a separate dental plan, Medicaid, or a Medicare Advantage plan that includes dental coverage. Some Medicare Advantage plans do cover cleanings and exams at no cost to you.
Can I get dental coverage if I have a pre-existing condition?
Yes. Dental plans cannot deny you coverage or charge you more because of a pre-existing condition like gum disease or missing teeth. However, they can impose waiting periods before covering major work like crowns or root canals. Preventive care usually has no waiting period.
What if I need a lot of dental work right now?
If you need expensive work immediately, a standalone dental plan may not help because of waiting periods. A Medicare Advantage plan with dental coverage might be faster since it usually has no waiting periods. A community health center or dental school can provide care at low cost while you wait for plan coverage to begin.
How do I know if I may have access to for Medicaid?
Income and asset limits vary by state. Contact your state Medicaid office or visit your state's Medicaid website to learn the limits and how to apply. You can also call 211 and ask for help finding your state Medicaid office.
Can I switch dental plans if I do not like mine?
Standalone dental plans can usually be switched during the annual open enrollment period (typically October through December) or if you have a may have access to life event like moving to a new state. Medicare Advantage plans can be switched during the annual open enrollment period or during the Medicare Advantage open enrollment period in January and February. Outside these windows, you are generally locked in until the next open enrollment.