What Original Medicare covers
Medicare.gov says Original Medicare doesn't cover dental services like routine cleanings, fillings, tooth extractions, or items like dentures and implants. It may cover dental care that's linked to the success of a covered medical treatment, for example:
- Some dental services you get when you're admitted as a hospital inpatient, because of your medical condition or the severity of the procedure.
- An oral exam and dental treatment before a heart valve replacement, or before a bone marrow, organ or kidney transplant.
- A procedure, like a tooth extraction, to treat a mouth infection before cancer treatment such as chemotherapy, and treatment for complications during head and neck cancer treatment.
- Exams and treatment to remove an oral infection before and during Medicare-covered dialysis for end-stage renal disease.
In these cases your usual Part A or Part B costs apply. Other choices are a separate dental policy, which works with any Medicare coverage (compare premiums, waiting periods and yearly maximums), a Medicare Advantage plan, or NC Medicaid.
Medicare Advantage
Medicare Advantage plans may offer extra benefits 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. CMS data show 106 Medicare Advantage plans open to everyone in North Carolina for 2027, and each county has its own list. If your plan is ending in 2027, see North Carolina plans ending in 2027.
NC Medicaid dental for people with Medicare
If you have Medicare and full NC Medicaid, you're in NC Medicaid Direct, and NC Medicaid pays for dental care under its Clinical Coverage Policy 4A. For adults, the policy covers:
- A periodic oral exam and a cleaning, each at least six calendar months apart.
- Fillings, extractions and some root canal treatment (for adults, limited to front teeth).
- Complete dentures, one per arch every 10 years, and partial dentures, one per arch every eight years, with prior approval. Implants aren't covered.
The policy says people with only MQB, North Carolina's Medicare Savings Program, aren't eligible for these dental services, because MQB pays Medicare costs only. PACE participants get dental care through their PACE program. To apply for NC Medicaid, use ePASS or contact your county Department of Social Services; the NC Medicaid Contact Center, 1-888-245-0179, can help you find your county office. See NC Medicaid and Medicare.
Get help
A licensed insurance agent who works 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. You can request a call from a licensed insurance agent, or see plans for your ZIP code. For what Medicare covers overall, see Medicare basics.
Related questions
Does Medicare cover hearing aids in North Carolina?
Exams yes, hearing aids no.
Does Medicare cover eye exams and glasses?
What Part B covers for your eyes.
Can I keep my doctor with Medicare?
Networks, assignment and the State Health Plan.
Sources
- Medicare.gov — Dental services
- NC Medicaid — Clinical Coverage Policy 4A, Dental Services (amended Dec. 15, 2023)
- NC Medicaid — Medicaid Health Plans and Programs
- NC Medicaid — How to apply
- CMS — CY2027 Medicare Advantage and Part D Landscape files
More questions in this guide
- Can I keep my doctor when I go on Medicare in North Carolina?
- Does Medicare cover assisted living in North Carolina?
- Does Medicare cover eye exams and glasses in North Carolina?
- Does Medicare cover hearing aids in North Carolina?
- Does Medicare cover home health care in North Carolina?
- Does Medicare cover mental health care in North Carolina?
- Does Medicare cover nursing home care in North Carolina?
- How do I get rides to the doctor with Medicare in North Carolina?
Part of the guide: Medicare basics for North Carolinians · All questions
Frequently asked questions
Does Medigap cover dental in North Carolina?
No. Medigap policies help pay costs for services Original Medicare covers. Because Original Medicare doesn't cover routine dental care, Medigap doesn't either.
Does NC Medicaid cover dental for adults with Medicare?
Yes, if you have full NC Medicaid. NC Medicaid's dental policy covers adult cleanings and exams about every six months, fillings, extractions and, with prior approval, dentures. Help from an MQB Medicare Savings Program alone doesn't include dental care.
Does NC Medicaid pay for dental implants?
No. NC Medicaid's dental policy (Clinical Coverage Policy 4A) lists implant services as not covered. It covers one complete denture per arch every 10 years and one partial denture per arch every eight years, with prior approval.
Medicare in your North Carolina county
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