What Medicare covers
Medicare.gov says that in most cases Medicare doesn't cover dental services like routine cleanings, fillings, tooth extractions, or items like dentures and implants. It may cover:
- Some dental services you get as a hospital inpatient, when your medical condition or the severity of the procedure requires a hospital stay.
- Dental services directly tied to the success of certain covered medical treatment, such as an oral exam and dental treatment before a heart valve replacement or a bone marrow, organ or kidney transplant.
- Treatment of a mouth infection, such as a tooth extraction, before cancer treatment like chemotherapy, and treatment for complications of head and neck cancer treatment.
- Dental or oral exams, and necessary treatment of an oral or dental infection, before and during Medicare-covered dialysis for people with end-stage renal disease.
For covered dental services under Part B, you pay 20% of the Medicare-approved amount after the Part B deductible ($283 in 2026). For anything Medicare doesn't cover, you pay the full cost.
Apple Health dental for adults with Medicare
Washington Apple Health covers dental care for adults 21 and older directly, using your ProviderOne services card, and the coverage works the same if you also have Medicare. According to the Health Care Authority, covered services for adults include:
- Routine exams and cleanings, X-rays and fluoride
- Fillings and extractions
- Root canals on front teeth
- Dentures and partials
- Stainless steel crowns
Not covered for adults: bridges, porcelain crowns, orthodontics, implants and root canals on premolars and molars. People enrolled in Developmental Disabilities Community Services get some additional services. To find a dentist who takes Apple Health, use HCA's provider search, call DentistLink at 1-844-888-5465, or call Apple Health customer service at 1-800-562-3022.
These benefits come with full Apple Health coverage. A Medicare Savings Program on its own pays Medicare costs and doesn't include dental. If your income is limited, check whether you qualify for full Apple Health; see Apple Health and Medicare.
Other ways to pay for dental care
- Medicare Advantage. Medicare Advantage plans may offer extra benefits that Original Medicare doesn't cover, such as dental, vision, hearing or fitness. Extra benefits vary by plan and county, may have limits and costs, and not every plan offers them. Check a plan's Summary of Benefits or Evidence of Coverage.
- Stand-alone dental insurance. Individual dental plans are sold separately from Medicare. Read the waiting periods, annual maximums and what counts as major care.
- Retiree or union coverage. Some retiree plans include dental; check what yours offers before you drop it.
- Tribal and community clinics. American Indians and Alaska Natives may get dental care through Indian Health Service, tribal or urban Indian programs; see tribal health and Medicare.
Get help
A licensed insurance agent with Benefits Life can walk you through how plans from the companies they work with handle dental care, at no cost to you: (206) SENIORS (206-736-4677), TTY 711. See also what Medicare doesn't cover.
Related questions
Does Apple Health pay Medicare premiums?
Medicare Savings Programs in Washington.
Can I have Apple Health and Medicare Advantage?
How the two fit together.
Does Medicare work in Canada?
Care across the border.
Sources
- Medicare.gov — Dental services
- Washington State Health Care Authority — How do I get dental care?
- Health Care Authority — Age 65 and older or Medicare eligible
- Medicare.gov — Medigap
Frequently asked questions
Does Medigap pay for dental?
No. Medigap policies help pay Original Medicare's deductibles and coinsurance, so they don't cover services Medicare doesn't cover, such as routine dental care.
What dental care does Apple Health cover for adults?
For adults 21 and older, the Health Care Authority lists exams and cleanings, X-rays, fillings, fluoride, extractions, root canals on front teeth, dentures and partials, and stainless steel crowns. It doesn't cover bridges, porcelain crowns, braces, implants or root canals on back teeth.
I have Medicare and only QMB. Do I get Apple Health dental?
A Medicare Savings Program alone, such as QMB, pays Medicare costs; it doesn't add Apple Health services like dental. Dental benefits come with full Apple Health coverage.
Do Medicare Advantage plans cover dental?
Medicare Advantage plans may offer extra benefits that Original Medicare doesn't cover, such as dental, vision, hearing or fitness. Extra benefits vary by plan and county, may have limits and costs, and not every plan offers them. Check a plan's Summary of Benefits or Evidence of Coverage.
Medicare in your Washington county
Plans, local agents and help, county by county: Adams · Asotin · Benton · Chelan · Clallam · Clark · Columbia · Cowlitz · Douglas · Ferry · Franklin · Garfield · Grant · Grays Harbor · Island · Jefferson · King · Kitsap · Kittitas · Klickitat · Lewis · Lincoln · Mason · Okanogan · Pacific · Pend Oreille · Pierce · San Juan · Skagit · Skamania · Snohomish · Spokane · Stevens · Thurston · Wahkiakum · Walla Walla · Whatcom · Whitman · Yakima
