Does Medicare Cover Tooth Extractions?
Medicare Benefits Solutions
Dec 24, 2021
Modern dental technology and techniques have allowed many people to save teeth that would have normally needed to be extracted in the past. Caps, crowns, root canals and more are all dental solutions that provide alternatives to tooth extraction. Unfortunately, as advanced as dental technology has become, there are still times when extraction is the only viable option to protect health and move forward with other procedures like dental implants and bridges.
When it comes to Original Medicare and any type of dental coverage, benefits are usually limited. Overall, Original Medicare Part A and Part B do not provide a dedicated dental benefit. Instead, it does cover medically necessary care related to oral health due to illness or injury.
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Coverage for Dental Care Services
Routine care such as dental visits, x-rays, fillings, extractions and root canals are not covered by Medicare. Instead, Medicare may cover the cost of surgical procedures related to dental problems, including injuries to the mouth or illnesses affecting oral tissue, as long as the care provided is medically necessary to preserve overall health.
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If dental services are covered, they will follow the standard parts of Medicare coverage as follows:
Medicare Part A
Medicare Part A is the inpatient benefit, and it covers hospital care and care administered in a skilled nursing facility. If you are hospitalized due to a dental or oral emergency, Medicare Part A would supply coverage. Once again, the need for care must be medically necessary to protect overall health in order to be considered for coverage.
Medicare Part B
Medicare Part B is the outpatient benefit, and it covers things like doctor visits, blood work and clinical diagnostic services. In terms of tooth extractions, you may receive coverage from Medicare Part B if you were to develop an oral infection after a tooth extraction or if you needed to have blood work prior to a tooth extraction to check for things like platelet counts.
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Medicare Part D
Medicare Part D is the prescription drug benefit. It covers prescription medications available through retail pharmacies that are meant for home use. If you have a tooth extracted, you may need to take antibiotics or pain medications. In such cases, Medicare may cover your prescriptions under Part D.
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Medicare Advantage and Tooth Extraction Services
Medicare Advantage plans function similarly to Original Medicare plans in that they provide Part A and B benefits for inpatient and outpatient care, respectively. The difference is that Medicare Advantage plans often provide additional coverage not supplied under Original Medicare.
This means that a Medicare Advantage plan may offer more flexibility when it comes to dental care and tooth extractions. You will need to contact your existing Medicare Advantage plan provider to discuss the specifics of your plan to understand your benefits or compare plans to find one that meets your health and dental needs.
How is Tooth Extraction Performed?
At its core, tooth extraction means physically pulling the tooth and its roots from the gums. This is done using standard numbing agents and fairly simple dental tools. If a tooth has become badly decayed or is at risk of breaking during the extraction process, your dental professional may need to utilize more technical and invasive techniques, including dental surgery.
Once a tooth is extracted, the cavity left behind is usually left to heal on its own. Gum tissue grows around the opening, and in some cases, a filler material may need to be inserted. After the healing process, a dental implant may be placed or the space may be used to seat a bridge.
TIP: For more great orthodontic care tips read our companion blog: Dental Care for Older Adults: Maintaining Healthy Teeth and Gums.
How Much Does a Tooth Extraction Cost?
In the United States, the average tooth extraction procedure costs between $100 and $200. If a tooth has become impacted, the cost can go much higher, ranging into thousands of dollars. Other factors can affect the cost, including the need for surgical intervention, sedation medication and monitoring and the need for multiple visits.
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