Is there a co-pay for dental procedures if you have Medicare?


Quick Answer

Medicare Part A covers dental care under limited circumstances for procedures that take place during a hospital admission, according to Medicare.gov. Patients pay the first $1,260 of the costs associated with their hospital stays under Medicare Part A and then pay a copay for each day in the hospital after 60 days, states WebMD. Most dental care is explicitly excluded from the Medicare program.

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Full Answer

Medicare does not cover routine dental care such as cleanings, fillings, dentures or extractions, states Medicare.gov. Medicare does cover dental services that are an indispensable part of covered health care procedures. For example, patients who have kidney or heart valve transplants have dental exams as part of their pre-operative work, and these exams are covered. If a patient requires hospitalization as a result of dental care that was not covered, the hospital stay is covered, as of 2015.

Medicare originally excluded all dental work, but Congress amended the program in 1980 to allow for Medicare to cover hospital admissions as a result of dental care. Medicare Part A does not charge a copay for the first 60 days of a hospital stay but charges $315 for per day for stays between 61 and 90 days, says WebMD. Thereafter, patients pay a copay of $630 for each day.

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