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 those cases your usual Part A or Part B costs apply. If a dentist isn't sure Medicare will pay, ask before treatment.
OHP dental for Oregonians with Medicare
This is the biggest Oregon difference. OHA says OHP "covers things Medicare does not, such as rides to appointments and dental care." Most OHP members with Medicare have the OHP with Limited Drug benefit: the same services as OHP Plus except drugs Part D covers. OHA lists OHP dental for all members as:
- Checkups, X-rays, and cleaning with fluoride varnish.
- Fillings, extractions and stainless steel crowns on back teeth.
- Full dentures every 10 years and partial dentures every five years.
- Specialist care and emergency or urgent dental care.
If your CCO covers your dental care, call your CCO to find a dentist. You can find your CCO with OHA's CCO tools; see coordinated care organizations and Medicare and OHP together.
Other dental options in Oregon
| Option | What it is | Things to check |
|---|---|---|
| Medicare Advantage plan | May offer dental as an extra benefit | The plan's Summary of Benefits or Evidence of Coverage |
| Individual dental policy | Separate insurance that works with any Medicare coverage | Premium, waiting periods, yearly maximum, dentist network |
Medicare Advantage plans may offer extra benefits 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 61 Medicare Advantage plans open to everyone in Oregon for 2027, but none in Grant, Harney, Lake, Umatilla and Union counties. See your county. You can request a call from a licensed insurance agent, or see plans for your ZIP code.
Related questions
Does Medicare cover vision in Oregon?
Eye exams and glasses.
Does Medicare cover hearing aids in Oregon?
Another common gap.
Can I have Medicare and OHP?
How the two work together.
Sources
- Medicare.gov — Dental services
- Oregon Health Authority — OHP dental care
- Oregon Health Authority — OHP and Medicare
More questions in this guide
- Does Medicare cover acupuncture in Oregon?
- Does Medicare cover ambulance service in Oregon?
- Does Medicare cover annual physicals in Oregon?
- Does Medicare cover assisted living in Oregon?
- Does Medicare cover bone density tests in Oregon?
- Does Medicare cover cataract surgery in Oregon?
- Does Medicare cover chiropractic care in Oregon?
- Does Medicare cover a colonoscopy in Oregon?
- Does Medicare cover CPAP machines in Oregon?
- Does Medicare cover diabetic supplies in Oregon?
- Does Medicare cover flu shots in Oregon?
- Does Medicare cover hearing aids in Oregon?
- Does Medicare cover home health care in Oregon?
- Does Medicare pay for in-home caregivers in Oregon?
- Does Medicare cover mammograms in Oregon?
- Does Medicare cover me when I travel or spend winters outside Oregon?
- Does Medicare cover medical marijuana in Oregon?
- Does Medicare cover memory care in Oregon?
- Does Medicare cover mental health care in Oregon?
- Does Medicare cover naturopathic doctors in Oregon?
- Does Medicare cover nursing home care in Oregon?
- Does Medicare cover oxygen therapy in Oregon?
- Does Medicare cover physical therapy in Oregon?
- Does Medicare cover prostate cancer screening in Oregon?
- Does Medicare cover psilocybin therapy in Oregon?
- Does Medicare cover skilled nursing care in Oregon?
- Does Medicare cover the shingles vaccine in Oregon?
- Does Medicare cover transportation to medical appointments in Oregon?
- Does Medicare cover vision care in Oregon?
- Does Medicare cover wheelchairs in Oregon?
Part of the guide: Learn Medicare — the Oregon starter guide · All questions
Frequently asked questions
Does Medigap cover dental?
No. Medigap policies help pay costs for services Original Medicare covers. Because Original Medicare doesn't cover routine dental care, Medigap doesn't either.
What dental care does OHP cover for adults with Medicare?
OHA lists checkups, X-rays, cleanings, fillings, extractions, some crowns, and full or partial dentures on a set schedule, plus specialist and urgent care.
How do I find an OHP dentist?
If your CCO covers your dental care, call your CCO. If you're not in a CCO for dental, OHA suggests calling OHP Care Coordination at 800-562-4620 or OHP Client Services at 1-800-273-0557.
Will Medicare pay for an extraction before heart surgery?
Possibly. Medicare.gov says Original Medicare may cover an oral exam and needed dental treatment before a heart valve replacement or certain transplants. Ask the dentist and the surgical team to confirm before treatment.
Medicare in your Oregon county
Plans, local agents and help, county by county: Multnomah · Washington · Clackamas · Lane · Marion · Jackson · Deschutes · Linn · Douglas · Yamhill · Benton · Polk · Josephine · Umatilla · Klamath · Coos · Columbia · Lincoln · Clatsop · Malheur · All 36 counties →
