What Original Medicare covers
Medicare.gov says Original Medicare generally doesn't cover routine cleanings, fillings, tooth extractions, or items like dentures and implants. It may cover dental services in these situations:
- Some dental services you get as a hospital inpatient, when you're admitted for a dental procedure because of an underlying medical condition or the procedure's severity.
- An oral exam and dental treatment before a heart valve replacement, or before a bone marrow, organ or kidney transplant.
- Removing a tooth to treat a mouth infection before cancer treatment such as chemotherapy.
- Treating a complication that arises during head and neck cancer treatment.
- Dental or oral exams, and tests and treatment to remove an oral or dental infection, before and during dialysis for end-stage renal disease.
In these cases your usual Part A or Part B costs apply. If a dentist isn't sure Medicare will pay, ask before treatment.
Medicare Advantage
Medicare Advantage plans may offer extra benefits that Original Medicare doesn't cover, such as dental, vision, hearing, fitness, transportation or telehealth. 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.
If dental care matters to you, read those documents closely: which dentists are in the network, whether there's a yearly dollar limit, how many cleanings are covered, and whether there are waiting periods for crowns, dentures or implants. Texas has 214 Medicare Advantage plans open to everyone in 2027, and choices differ by county. See Medicare Advantage in Texas.
Standalone dental insurance
If you keep Original Medicare, or want more dental coverage, you can buy an individual dental policy from a private insurance company. These policies have their own premiums, yearly maximums, waiting periods and networks. The Texas Department of Insurance (TDI) licenses the companies and agents that sell them and takes complaints at 1-800-252-3439. Dental discount programs are not insurance; they offer reduced fees at participating dentists.
Texas Medicaid and dental
If you have both Medicare and full Texas Medicaid, ask HHSC what dental services Medicaid covers for adults. STAR+PLUS health plans may also offer extra services, and HHSC publishes charts comparing them by area. See what is STAR+PLUS.
Crossing the border for dental work? Some Texans near the border see dentists in Mexico. Medicare doesn't pay for that care. See does Medicare work in Mexico.
Get help
A licensed insurance agent with Benefits Life can walk you through dental options with Medicare and compare plans from the companies they work with, at no cost to you, at (512) 265-6565, TTY 711. You can also see plans in your ZIP code.
Related questions
Does Medicare work in Mexico?
Medicare's rare exceptions and Medigap travel coverage.
Can I switch Medicare Advantage plans after open enrollment?
When you can change to a plan that fits.
What is STAR+PLUS?
Texas Medicaid for adults 65+ and people with disabilities.
Sources
- Medicare.gov — Dental services
- Medicare.gov — What Medigap covers
- Texas Medicaid Provider Procedures Manual — Medicaid managed care (dental for adults 21 and older)
- Texas HHSC — STAR+PLUS
- Texas Department of Insurance — Consumer Help Line
Frequently asked questions
Does Medigap cover dental in Texas?
No. Medigap policies pay part of the costs for services Original Medicare covers. Because Original Medicare doesn't cover routine dental care, Medigap doesn't either.
Can I buy dental insurance separately?
Yes. Standalone dental policies are sold by private insurance companies and work alongside Original Medicare or a Medicare Advantage plan. The Texas Department of Insurance licenses the companies and agents that sell them. Compare premiums, waiting periods for major work, yearly maximums and dentist networks.
Does Texas Medicaid cover dental for adults with Medicare?
Texas Medicaid's dental services for adults 21 and older are handled through the state's Medicaid claims administrator rather than through children's dental plans, and STAR+PLUS health plans may add extra dental services that vary by plan and area. Ask HHSC or your STAR+PLUS plan what's covered for you.
Will Medicare pay for dental work in Mexico?
No. Original Medicare doesn't cover routine dental care anywhere, and it pays for care in Mexico only in rare hospital cases.
Medicare in your Texas county
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