Medicare Advantage vs. Standalone Dental Insurance for Seniors

Original Medicare does not cover most dental care. As we explain in our article on whether Medicare covers dental, the law specifically excludes services related to the care, treatment, filling, removal, or replacement of teeth. This leaves millions of seniors looking for dental coverage through other options.

The two most common paths to dental coverage for Medicare beneficiaries are Medicare Advantage plans with built-in dental benefits and standalone dental insurance plans from private companies. Each approach has distinct advantages and drawbacks. This article provides a side-by-side comparison to help you decide which option fits your situation.

How Medicare Advantage Dental Benefits Work

Medicare Advantage (Part C) plans are offered by private insurance companies approved by Medicare. About 98 percent of these plans in 2026 include some form of dental benefit, according to CMS data. Dental coverage in Medicare Advantage is considered a supplemental benefit, meaning it goes beyond what Original Medicare provides. For details on which plans offer the strongest dental benefits, see our guide to Medicare Advantage plans with the best dental coverage.

Dental benefits in Medicare Advantage plans generally fall into two tiers:

• Preventive dental: Covers routine exams, cleanings (usually two per year), and X-rays. Many plans offer these services with no additional copay beyond the plan premium.
• Comprehensive dental: Some plans also cover fillings, crowns, root canals, dentures, and even implants. These services typically come with copays or coinsurance. Plans with comprehensive dental usually have an annual maximum benefit, typically between $1,000 and $3,000.

The cost of dental benefits is generally built into the Medicare Advantage plan's overall premium. Many plans have $0 monthly premiums beyond the standard Part B premium, which means the dental benefit may effectively come at no extra charge. However, you still pay the Part B premium, and you are required to use the plan's provider network for all your health care, including dental.

How Standalone Dental Insurance Works for Seniors

Standalone dental insurance is a separate policy from a private insurance company. It is not connected to Medicare and is not regulated by CMS. You can buy a standalone dental plan whether you have Original Medicare, a Medigap policy, or even a Medicare Advantage plan.

Standalone dental plans for seniors typically use a DPPO (Dental Preferred Provider Organization) structure with the following features:

• Monthly premiums: $20 to $60 per month depending on the plan and coverage level
• Annual deductible: Usually $50 to $100 for basic and major services; preventive services often have no deductible
• Coverage tiers: Typically follows the 100-80-50 structure: preventive at 100 percent, basic at 80 percent, major at 50 percent
• Annual maximum: The plan pays up to $1,000 to $2,000 per year. You pay everything above the maximum out of pocket.
• Waiting periods: Many plans require waiting periods of 3 to 6 months for basic services and 6 to 12 months for major services before coverage begins

Standalone dental plans can be enrolled in at any time throughout the year. There is no limited enrollment window like there is for Medicare Advantage.

Side-by-Side Comparison

Here is how Medicare Advantage dental and standalone dental plans compare across the most important factors:

• Monthly premium: Medicare Advantage dental is typically $0 extra (built into plan). Standalone dental costs $20 to $60 per month.
• Annual maximum: Medicare Advantage dental ranges from $1,000 to $3,000. Standalone dental is typically $1,000 to $2,000.
• Preventive coverage: Both typically cover cleanings, exams, and X-rays at 100 percent or with a small copay.
• Major services: Varies by plan for both. Medicare Advantage may cover 50 percent of crowns and dentures. Standalone typically covers major work at 50 percent after the waiting period.
• Waiting periods: Medicare Advantage dental usually has no waiting periods. Standalone plans often have 6 to 12 month waits for major services.
• Provider network: Medicare Advantage requires using the plan's dental network. Standalone DPPO plans have their own network but allow out-of-network use at higher cost.
• Enrollment: Medicare Advantage limited to Annual Enrollment Period and special periods. Standalone dental available year-round.

When Medicare Advantage Dental Is the Better Choice

Medicare Advantage dental benefits may be the right fit if:

• You want to keep costs low: The dental benefit is included in the plan premium, which is often $0 beyond your Part B premium. This can save you $240 to $720 per year compared to a standalone dental plan.
• You prefer simplicity: Having medical, dental, and often vision and hearing benefits all in one plan is simpler than managing multiple policies from different companies.
• You need dental coverage right away: Medicare Advantage dental benefits generally have no waiting periods. Your coverage starts as soon as your plan is effective, including for major services.
• You are comfortable with a provider network: Medicare Advantage plans require you to use in-network providers for all your care. If there are good dentists and doctors in the plan's network in your area, this may not be a drawback.

When Standalone Dental Insurance Is the Better Choice

A standalone dental plan may make more sense if:

• You want to keep Original Medicare and Medigap: If you prefer the freedom to see any doctor that accepts Medicare without network restrictions, staying with Original Medicare and adding a standalone dental plan lets you keep that flexibility.
• You have a dentist you want to keep: If your current dentist is not in any Medicare Advantage dental network but participates in a standalone dental plan's network, the standalone plan is the better option.
• Your Medicare Advantage plan has limited dental: If your Medicare Advantage plan only covers preventive dental and you need major work, a standalone plan with comprehensive coverage may provide better benefits.
• You want out-of-network options: Standalone DPPO plans typically allow you to see out-of-network dentists at a higher cost. Medicare Advantage dental usually requires you to stay in network.

Cost Comparison Example

To illustrate the cost differences, consider a senior who needs two cleanings, one exam, one set of X-rays, and one crown in a given year. A crown typically costs $800 to $1,500 out of pocket.

With Medicare Advantage dental: The preventive services are covered at no extra cost. The crown may be covered at 50 percent after a copay, meaning you might pay $400 to $750 for the crown. Your total cost for the year could be $400 to $750 with no additional dental premium.

With standalone dental: You pay $20 to $60 per month in premiums, totaling $240 to $720 per year. Preventive services are covered at 100 percent. After meeting the deductible ($50 to $100), the crown is covered at 50 percent, leaving you with $400 to $750 out of pocket for the crown. Your total cost is $690 to $1,470 including premiums.

In this example, the Medicare Advantage option is less expensive. However, the standalone plan offers more flexibility in choosing your dentist and allows you to keep Original Medicare for your medical care.

Important Considerations Before Switching

Before choosing between Medicare Advantage dental and standalone dental, consider the bigger picture. Switching to Medicare Advantage affects more than just your dental care. It changes how you receive all your Medicare benefits. Review our article on the pros and cons of Medicare Advantage before making a decision.

Key things to think about:

• Medigap impact: If you leave Original Medicare for Medicare Advantage, you must drop your Medigap plan. If you later want to return to Original Medicare, you may not be able to get a Medigap plan at the same rate or without medical underwriting, depending on your state and timing.
• Network restrictions: Medicare Advantage uses provider networks for medical care, not just dental. Make sure your doctors, specialists, and preferred hospital are all in the plan's network.
• Geographic limitations: Medicare Advantage plans are local, meaning coverage works best in your plan's service area. If you travel frequently or spend winters in another state, Original Medicare with a standalone dental plan may provide better coverage across locations.
• Ongoing dental needs: If you anticipate needing major dental work in the next year, a Medicare Advantage plan with no waiting period may be advantageous. If your dental needs are primarily preventive, the lower cost of Medicare Advantage dental may be enough.

The Bottom Line

Both Medicare Advantage dental benefits and standalone dental plans can help fill the dental coverage gap in Original Medicare. Medicare Advantage dental is typically less expensive and more convenient, bundling dental with your medical coverage and often charging no extra premium. Standalone dental plans offer more flexibility, especially if you want to keep Original Medicare and your Medigap plan or prefer to choose your own dentist without network restrictions.

The right choice depends on your overall health care preferences, not just your dental needs. Consider the trade-offs between provider networks, costs, and coverage levels. Compare specific plans available in your area, and pay close attention to annual maximums, waiting periods, and network participation for dentists you trust.

Plans and coverage vary by location. This article is for educational purposes and does not constitute individual advice. Contact a licensed insurance agent or visit Medicare.gov to explore the specific plans available to you.