What Original Medicare covers
Medicare.gov says Original Medicare generally doesn't cover routine cleanings, fillings, tooth extractions, or items like dentures and implants. It may cover dental services in situations like these:
- Some dental services you get as a hospital inpatient, when you're admitted for a dental procedure because of an underlying medical condition or the procedure's severity.
- An oral exam and needed dental treatment before a heart valve replacement, or before a bone marrow, organ or kidney transplant.
- Removing a tooth to treat a mouth infection before cancer treatment such as chemotherapy.
- Dental or oral exams and treatment to remove an infection before and during dialysis for end-stage renal disease.
In these cases your usual Part A or Part B costs apply. If a dentist isn't sure Medicare will pay, ask before treatment.
Your dental options in Oklahoma
| Option | What it is | Things to check |
|---|---|---|
| Medicare Advantage plan | May offer dental as an extra benefit; varies by plan and county | The plan's Summary of Benefits or Evidence of Coverage |
| Individual dental policy | Separate insurance that works with any Medicare coverage | Premium, waiting periods for major work, yearly maximum |
| Dental discount program | Not insurance; reduced fees at participating dentists | Which dentists take it, and the fee |
| SoonerCare adult dental | Limited benefit for adult SoonerCare members | Whether your SoonerCare coverage includes it |
Medicare Advantage
Medicare Advantage plans may offer extra benefits that Original Medicare doesn't cover, 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 50 Medicare Advantage plans open to everyone in Oklahoma for 2027, and seven western and Panhandle counties have only special needs plans. See Medicare Advantage in Oklahoma.
SoonerCare and dental
OHCA describes SoonerCare dental for adults as limited. Its 2021 expansion added preventive care (cleanings, fluoride and periodontal scaling), exams, X-rays, fillings, and partial and full dentures to the medically necessary extraction benefit. OHCA also says adults living in nursing facilities can get dentures. If you have Medicare and SoonerCare, Medicare doesn't cover routine dental, so ask OHCA how your SoonerCare dental works. See SoonerCare 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 or glasses?
What Part B covers and what it doesn't.
How do I get rides to the doctor?
SoonerRide and other options.
Can I keep my doctor?
Networks and assignment.
Sources
- Medicare.gov — Dental services
- Oklahoma Health Care Authority — SoonerCare Dental
- Oklahoma Health Care Authority — OHCA providing additional dental benefits for adult SoonerCare members (July 2021)
- Oklahoma Health Care Authority — SoonerCare benefits
- Oklahoma Insurance Department — Contact us
More questions in this guide
- Can I keep my doctor when I go on Medicare in Oklahoma?
- Does Medicare cover hearing aids or glasses in Oklahoma?
- Does Medicare pay for an air ambulance in Oklahoma?
- How do I get rides to the doctor in Oklahoma with Medicare?
Part of the guide: Medicare basics for Oklahomans · All questions
Frequently asked questions
Does Medigap cover dental?
No. Medigap policies pay part of the costs for services Original Medicare covers. Because Original Medicare doesn't cover routine dental care, Medigap doesn't either.
Does SoonerCare cover dental for adults with Medicare?
SoonerCare has a limited adult dental benefit. In 2021, OHCA added cleanings, exams, X-rays, fillings and partial and full dentures to its existing medically necessary extraction benefit for adult members. If you have both Medicare and full SoonerCare, ask OHCA or your dentist what's covered for you.
Can I buy dental insurance separately in Oklahoma?
Yes. Private companies sell individual dental policies that work alongside Original Medicare or Medicare Advantage. The Oklahoma Insurance Department licenses insurers and agents and takes complaints. Compare premiums, waiting periods, yearly maximums and dentist networks.
Medicare in your Oklahoma county
Plans, local agents and help, county by county: Oklahoma · Tulsa · Cleveland · Canadian · Comanche · Rogers · Wagoner · Payne · Pottawatomie · Creek · Muskogee · Garfield · Grady · Washington · Logan · Bryan · Le Flore · Carter · Cherokee · McClain · All 77 counties →
