Does Medicare Cover Dental Extractions?

Medicare Parts A & B do not cover dental extractions under normal circumstances, though there are a few medical exceptions.

While Medicare services cover a wide range of outpatient treatments and procedures, it has never covered dental services. However, should your dental condition require you to be hospitalized, then Part A will likely offer coverage for inpatient care. If the procedure was medically necessary in an outpatient clinic, then Part B may help cover these costs.

There are other coverage options if you don’t think Original Medicare will cover your dental extraction. Medicare Advantage, Medicaid, private dental insurance or community health clinics are other options to help lower your costs.

Medicare will provide coverage for a dental extraction if the tooth was extracted in order to perform a different Medicare-covered procedure. This means, the dental extraction was medically necessary for another service.

The U.S. Centers for Medicare & Medicaid Services requires you to meet specific exceptions for dental extraction coverage.

Other dental service exceptions under Original Medicare coverage include oral exams in preparation for a kidney or heart valve replacement and facial reconstruction.

Most Medicare Advantage plans will cover dental extractions. In 2022, the Kaiser Family Foundation found that 96% of Medicare Advantage plans provide dental benefits, but not all of those plans cover dental extractions.

Preventive services, like routine cleaning, are usually covered under Medicare Advantage plans, but a dental extraction may require cost-sharing. Typically, 80% of a dental extraction procedure is covered but each plan varies in coverage.

Private dental insurance and Medicaid are other options for dental extraction coverage. However, since these options aren’t under Medicare, you will be faced with managing multiple plans and premiums.

Most private dental insurance plans cost between $20 to $60 per month, depending on where you live and what plan you choose. These monthly premiums are in addition to your Medicare premiums, and there could be deductibles and coinsurance costs as well. Since a dental extraction isn’t a preventive service, there is likely a coinsurance charge if you choose this route.

Medicaid coverage and costs are determined by state. Most states offer coverage for emergency dental procedures for adults, but less than half the states offer comprehensive dental care, which includes dental extractions. The Center for Health Care Strategies offers a chart that clarifies each state’s coverage, costs and restrictions.

Dental extractions can cost up to $600 per tooth without insurance at a standard dentist office. This price will fluctuate depending on if your tooth is impacted, the complexity of the removal and which tooth is being extracted.

There are other more affordable options to get your teeth extracted without insurance, such as dental schools, community health clinics and the dental lifeline network. Each option has resources to help you find affordable dental care in your area.

At a community health clinic, a dental extraction typically costs around $125.

Dental extraction at a dental school typically costs 25% to 50% less than a standard dentist office. But the price will vary depending on how complicated the tooth removal is.

If you qualify for a dental lifeline network tooth extraction, your procedure could be free, but there is an application and a waiting list to be approved. If you have Medicaid dental coverage, you must use Medicaid coverage before applying to the dental lifeline network.