If you are on Medicare in Broward County and wondering whether it pays for the dentist, here is the short answer: Original Medicare does not cover routine dental care. Cleanings, fillings, crowns, extractions and dentures are all left out. For most people, dental benefits on Medicare come from a Medicare Advantage plan or from a separate dental policy, and the details change from one plan to the next.
The timing matters. Medicare's Open Enrollment Period runs from October 15 to December 7, and the plan you pick takes effect on January 1. If dental work is on your list for next year (a crown you have put off, a partial that no longer fits, a tooth that needs to come out), this is the window to choose coverage that actually helps with it.
Metropolitan Smile Design is a bilingual general and cosmetic dental office in Tamarac. What Medicare covers is one of the questions we hear most from patients in Tamarac, Margate and Sunrise, especially in the fall, so this is the answer we give them.
- What Original Medicare covers and leaves out
- How Medicare Advantage dental benefits work
- Six questions to ask before December 7
- Why the calendar matters for dental work
- If your plan does not cover what you need
- Why putting off the dentist costs more later
- Checking your coverage with our Tamarac office
- Frequently Asked Questions
- Original Medicare (Parts A and B) does not cover cleanings, fillings, crowns, extractions, dentures or implants. Medigap does not add dental either.
- Many Medicare Advantage plans include dental, but it ranges from two cleanings a year to partial help with crowns and dentures, usually up to a yearly dollar limit.
- Open Enrollment runs October 15 to December 7, and changes start January 1. Check the dental summary, not just the premium.
- Ask whether your dentist is in the network, what the yearly maximum is, and whether major work has a waiting period or needs approval.
- If coverage falls short, a written estimate, phased treatment and monthly financing keep care affordable.
What Original Medicare covers and leaves out
Original Medicare is built around hospital care (Part A) and doctor visits (Part B). Its coverage rules leave out most dental care, including the services people need most often:
- Exams, cleanings and X-rays
- Fillings
- Crowns and bridges
- Extractions
- Dentures, partials and other dental devices
- Dental implants
There is a narrow exception. Medicare can pay for certain dental services that are tied to a medical treatment it already covers, such as a dental exam before an organ transplant or heart valve surgery, or dental care connected to radiation treatment for head and neck cancer. And if an emergency or complicated dental procedure needs a hospital stay, Part A may pay for the hospital care, but not for the dental work itself. These cases are coordinated with your doctor; they do not turn a routine checkup into a covered visit.
Medicare Supplement (Medigap) policies follow Original Medicare's rules, so they do not add routine dental coverage either. If your only coverage is Original Medicare plus Medigap, plan on paying for dental care yourself or adding a separate dental policy.
How Medicare Advantage dental benefits work
Medicare Advantage plans (Part C) are offered by private insurance companies approved by Medicare, and many of them include dental as an extra benefit. The word "dental" on a plan summary can mean very different things, though.
Some plans cover only preventive care: an exam, a cleaning and X-rays a set number of times a year. Others add fillings, extractions, root canals, crowns or dentures, usually with a yearly dollar limit and a share of the bill that you pay. Two plans with the same monthly premium can look nothing alike once you need more than a cleaning.
The parts that differ most between plans:
- The yearly maximum. Most plans cap what they pay for dental each year. One crown or a set of dentures can use a large share of it.
- The network. HMO plans often pay only for in-network dentists. PPO plans may pay part of the cost out of network, usually less.
- What counts as covered. Preventive care is the most common benefit. Crowns, dentures, root canals and especially implants are where plans differ.
- Your share. A copay per visit, or a percentage of the cost for each type of service.
- Limits on how often. For example two cleanings a year, X-rays once a year, or new dentures only every few years.
- Approval and waiting. Some plans need approval before major work, and some separate dental policies make you wait months before they cover it.
Six questions to ask before December 7
Before you choose a plan, look past the headline and find its dental benefit summary or Evidence of Coverage. These six questions cover what matters:
- Is my dentist in the network? Ask the plan, then call the dental office to confirm. Networks change from one year to the next.
- What is the yearly dental maximum? Compare it with the work you already know you need.
- Does it cover crowns, root canals, extractions and dentures, or only cleanings?
- What do I pay for each type of service? Look for the copay or the percentage you owe.
- Is there a waiting period or approval step for major work?
- Are implants covered at all? Many plans exclude them or limit them.
If a plan cannot answer these clearly, treat that as an answer. You can compare plans side by side on Medicare.gov's plan finder. For free, unbiased help, Florida's SHINE program (Serving Health Insurance Needs of Elders) counsels people on Medicare at no cost; you can reach it through the Elder Helpline at 1-800-963-5337.
Changes you make during open enrollment start on January 1. If you are already in a Medicare Advantage plan, the Medicare Advantage Open Enrollment Period from January 1 to March 31 lets you switch to another Advantage plan, or go back to Original Medicare, one time. Medicare.gov lists every enrollment period and who qualifies.
Why the calendar matters for dental work
Dental benefits on Medicare Advantage plans and on most dental policies usually run on the calendar year. The yearly maximum resets on January 1, and benefit you did not use generally does not carry over. If you are keeping your current plan and still have dental benefit left for 2026, you have about two months to use it.
Work that needs a dental lab, such as a crown or a bridge, often takes two to three weeks between visits, so starting in mid-December rarely finishes in the same year. For many single crowns we can skip the lab wait: our same-day crowns are designed and milled in the office in one visit.
If you are changing plans on January 1, ask before you start treatment that runs across both years which plan will pay for which part. Our guide to the annual maximum and the January 1 reset walks through year-end planning step by step.
If your plan does not cover what you need
Many people on Medicare pay for part or all of their dental care themselves. A few ways to keep it manageable:
- Ask for the cost in writing. After your exam, you get the price of treatment on paper before anything begins.
- Do it in phases. We treat pain and infection first and schedule the rest over the following weeks or months, which also spreads the cost.
- Pay monthly. CareCredit, Sunbit, Cherry and Alphaeon let you pay for larger work over time, subject to approval. Details are on our financing and insurance page.
- Add a separate dental policy. These are sold apart from Medicare; read the waiting periods and the yearly maximum before you buy.
- Start with the $65 first visit. If you have no dental coverage, new patients with healthy gums get an exam, digital X-rays and a basic cleaning for $65. It cannot be combined with dental insurance or other offers.
Call with your plan name and member ID. We check your dental benefit, give you an estimate and explain your options before you book treatment.
Contact our Tamarac officeWhy putting off the dentist costs more later
Dental problems rarely stay small. A cavity that needs a filling this year can need a crown or a root canal later, and untreated gum disease is one of the main reasons adults lose teeth. Regular exams and cleanings catch these problems while they are still simple to fix.
A few things make checkups more important as we get older. Many common medications cause dry mouth, and saliva is one of the mouth's main defenses against cavities. Dentures and partials need adjusting as the gums and jawbone change shape, and a denture that rubs or slips is harder to eat with. If you are weighing dentures against implants, an exam and X-rays give you real numbers to compare instead of guesses.
Checking your coverage with our Tamarac office
Bring your card or call us with your plan name and member ID. We accept most major PPO dental plans and check your benefits before treatment. For a Medicare Advantage plan, we check its dental benefit and give you an estimate of your share before you book. The final amount depends on how the plan processes the claim.
Metropolitan Smile Design is at 6510 N University Dr in Tamarac, open Monday to Friday from 8 AM to 5 PM, with a bilingual team in English and Spanish. We see patients from Tamarac, Margate, Sunrise, Lauderhill, Coral Springs and the rest of Broward County. Call (954) 322-3865 or send us a message.
Frequently Asked Questions
Does Medicare cover dental cleanings?
Original Medicare does not. Many Medicare Advantage plans cover preventive visits such as exams and cleanings, often twice a year, and some separate dental policies do too. Check the plan's dental benefit summary for how many visits a year it pays for.
Does Medicare pay for dentures?
Original Medicare does not pay for dentures or partials. Some Medicare Advantage plans with broader dental coverage pay part of the cost, usually up to the plan's yearly maximum and often with a limit on how often it will pay for a new set. Ask what share you pay before you choose the plan.
Does Medicare cover dental implants?
Original Medicare does not. Implants are often excluded or tightly limited in Medicare Advantage dental benefits as well, so check the plan's list of covered services. Monthly financing through CareCredit, Sunbit, Cherry or Alphaeon can spread the cost, subject to approval.
When can I change my Medicare plan to get dental coverage?
During the Open Enrollment Period, from October 15 to December 7, with changes starting January 1. If you are already in a Medicare Advantage plan, the Medicare Advantage Open Enrollment Period from January 1 to March 31 allows one switch to another Advantage plan or back to Original Medicare. Some life events, such as moving, open a Special Enrollment Period.
Will my Medicare Advantage dental benefit work at Metropolitan Smile Design?
It depends on the plan and its network. Call (954) 322-3865 with your plan name and member ID. We check the dental benefit and give you an estimate before you book treatment; the final amount depends on how the plan processes the claim.
What if I have no dental coverage at all?
You can still get care at a known price. New patients with healthy gums can start with a $65 visit that includes an exam, digital X-rays and a basic cleaning (it cannot be combined with insurance), and you get the cost of any treatment in writing before it starts. Financing is available for larger work, subject to approval.
