Does Medicare Cover Wisdom Tooth Extractions?

Wisdom tooth extraction may be covered by certain Medicare Advantage plans (Medicare Part C) that offer dental benefits. Original Medicare (Medicare Part A and Part B), however, does not typically cover routine dental care.

Learn more about your wisdom tooth extraction coverage options.

Does Original Medicare cover dental?

A wisdom tooth extraction is categorized by Medicare as a routine, non-emergency dental procedure. Thus, it is not typically covered by Original Medicare.

Medicare Part A (hospital insurance) might help cover the costs for certain dental services you receive while admitted as a hospital inpatient, but only in specific circumstances.

These situations might typically include:

• Emergency oral surgery
• Certain complicated dental procedures
• Dental care that is required as part of preparation for a medically necessary surgery

Wisdom tooth extraction doesn’t typically fall under the category of being an emergency or medically necessary for other surgeries.

If your circumstances do qualify you for Part A coverage of your wisdom teeth extraction, you are responsible for paying the Part A deductible ($1,364 per benefit period in 2019) before your coverage kicks in.

Without a Medicare Advantage plan that offers dental benefits or a standalone dental plan, wisdom tooth extraction can cost hundreds or dollars per tooth when paid out of pocket. And this estimate may not include the cost of X-rays, sedation or medications.

Some Medicare Advantage plans may cover dental care

Medicare Advantage, or Medicare Part C, is an alternative way for beneficiaries to get their Medicare Part A and Part B coverage. Many Medicare Advantage plans may also offer additional benefits not covered by Original Medicare, such as dental coverage.

By law, every Medicare Advantage plan must provide all the same benefits as Original Medicare. Some Medicare Advantage plans may include additional benefits for coverage not offered by Original Medicare, such as:

• Dental
• Vision
• Hearing
• Prescription drugs
• SilverSneakers and other wellness programs

You will still pay your Medicare Part B premium (as enrollment in Part A and Part B are required for Medicare Advantage eligibility) along with your Medicare Advantage premium. However, many Medicare Advantage plans feature $0 premiums, though $0 premium plans may not be available in all areas.

The popularity of Medicare Advantage plans has been soaring, thanks largely to beneficiaries who seek additional benefits like dental coverage. Plus, the average premiums for Medicare Advantage plans have been decreasing in recent years.

If you are a Medicare beneficiary (or are nearing Medicare eligibility) and want to find a Medicare Advantage plan that may help cover your wisdom tooth extraction, get help comparing plans available in your area.

Get started today by calling to speak with a licensed insurance agent.

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