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Why Medicare doesn't cover dental?

Medicare is a health insurance program administered by the federal government in the United States. It provides coverage for people over the age of 65, as well as those who are younger but have certain disabilities or conditions. Despite its comprehensive coverage for many aspects of healthcare, Medicare does not provide coverage for dental care. This can be a significant burden for many seniors, who often require dental care for conditions related to aging, such as gum disease and tooth loss. So, why doesn't Medicare cover dental care?


The primary reason why Medicare does not cover dental care is because of the way the program was designed. When Medicare was created in 1965, dental care was not considered a part of routine medical care. As a result, dental coverage was not included in the original legislation. The same is true for vision care and hearing aids, which are also not covered by Medicare.


There have been attempts over the years to expand Medicare to include dental coverage, but these efforts have not been successful. In fact, the Affordable Care Act of 2010 (ACA) included provisions for an optional dental benefit for adults, but it was never implemented due to lack of funding.


Another reason why Medicare does not cover dental care is the cost. Dental care can be expensive, and adding it to Medicare would be a significant cost for the program. According to the Kaiser Family Foundation, in 2018, Medicare spent only about 1% of its budget on dental care, while Medicaid spent about 2%. Expanding Medicare to cover dental care would require a substantial increase in funding, which could be difficult to obtain.


In addition, there is the issue of access to dental care. Even if Medicare were to cover dental care, many seniors might have trouble finding a dentist who accepts Medicare. According to a 2016 report from the American Dental Association, only about one-third of dentists in the U.S. accept Medicaid, which is a similar program to Medicare but provides coverage for low-income individuals.

Senior with there child looking a Medicare options

There is also the question of what dental services would be covered under Medicare. Dental care can be divided into three categories:

  • Comparing Preventive

  • Basic

  • Major Dental

Routine preventive care, such as cleanings and exams, and restorative care, such as fillings and extractions. While routine preventive care is relatively inexpensive, restorative care can be quite expensive. It is not clear what types of dental services Medicare would cover, and how much it would cost.


Finally, some argue that dental care should be covered under Medicare because it is essential to overall health. Poor oral health can lead to a variety of health problems, including heart disease, stroke, and diabetes. By covering dental care, Medicare could help prevent these conditions and reduce healthcare costs in the long run.



In conclusion, Medicare does not cover dental care primarily because it was not originally included in the program's design and because of the cost of adding it. While there have been efforts to expand Medicare to include dental coverage, these efforts have not been successful. Even if Medicare were to cover dental care, there are concerns about access to care, what services would be covered, and how much it would cost. Despite these challenges, there is a growing recognition of the importance of dental care to overall health, and it is possible that Medicare coverage of dental care could be expanded in the future.


About Preferred Senior Benefits in Meridian, Idaho

Medicare is a federal program that provides healthcare coverage to individuals 65 years or older. Original Medicare coverage is broken into two parts—Part A and Part B—and is accepted by nearly every doctor and hospital in the country. Medicare Part A covers inpatient or hospital stays, while Part B covers outpatient or medical care. Together, Part A and B cover about 80% of the typical healthcare costs seniors face. This leaves a few significant gaps in coverage. Medicare Supplement (Medigap) and Medicare Advantage plans are policies designed to help extend coverage, lessen costs, and ultimately give beneficiaries peace of mind. If you or someone you know would like more information about how to enroll in Original Medicare or one of the Medicare Advantage plans, call now to speak with a licensed agent (208) 818-2523. We can’t wait to help you learn about your options.

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