The retirement expense you may be missing
[October 28, 2026]
CHRISTINE BENZ of Morningstar
People often underestimate some expenses when planning for retirement.
In my conversations with older adults about their in-retirement
finances, they’ve repeatedly mentioned the cost of dental care. The
reasons are straightforward: Our teeth get worse as we age, and yet
dental care isn’t covered by Medicare (except for emergency dental
procedures for people who are hospitalized).
There are three main avenues to covering dental costs during retirement:
dental insurance, a Medicare Advantage program that covers dental care,
and paying out of pocket.
Buying stand-alone dental insurance
Older adults can purchase stand-alone dental insurance with monthly
premiums typically around $25 to $50. Coverage varies widely, however,
with plans typically capping the dollar amounts they’ll cover in a year.
Annual caps range from $1,000 to $2,500, providing scant protection
against extensive and costly procedures. Many plans impose waiting
periods that prevent you from receiving major procedures such as crowns
or root canals within the first six to 12 months of coverage.
Dental insurance will often entail using specific providers. Dental
health management organizations are the most restrictive, though they’re
also the most economical.
The bottom line: The insurance premiums plus the annual coverage limits
don’t point to a great economic case for carrying dental insurance into
retirement. One countervailing argument is that people without dental
insurance are more likely to go without dental care, according to data
from the Medical Expenditure Panel Survey.
Medicare Advantage dental care
Many Medicare Advantage plans include dental care, along with vision
care and hearing aids. Medicare Advantage is the managed-care,
private-insurance version of Medicare; enrollees have to choose from a
list of providers, so this won’t be a great option if your favorite
provider isn’t on the list.
From a big-picture standpoint, it would be a mistake to let dental
coverage—or any other ancillary service that a Medicare Advantage plan
might offer—drive the decision about whether to opt for Medicare
Advantage or traditional Medicare with a supplemental plan. True,
Medicare Advantage plans can be more affordable, but their out-of-pocket
limits can be high. Moreover, provider networks can be limiting, and
plans may require referrals to see specialists, which can slow down
care. Additionally, people switching out of Medicare Advantage into
traditional Medicare will need to undergo medical underwriting for
Medigap coverage.
The bottom line: All of these considerations suggest that dental
coverage should be a secondary factor when determining healthcare
coverage in retirement. If Medicare Advantage makes sense for your
situation, consider dental coverage an extra perk.
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A dentist holds a model of teeth and a toothbrush at the University
of Washington in Seattle on Aug. 3, 2018. (AP Photo/Elaine Thompson,
File)
 Paying out of pocket for dental
care
If you decide to cover dental care using your own assets, it can
help to do a little fact-finding to estimate how much to budget.
Look back on your dental costs over the past five years, before
factoring in insurance; budget for routine preventive care. In
addition, your dentist should be able to share a price list for
common procedures.
Consult with your dentist to get ahead of procedures you may need in
the near term. Then decide whether to get them done while you’re
working and covered by insurance or wait until retirement.
Health savings accounts are ideal assets to earmark for dental care
in retirement. Most dental procedures, save for cosmetic ones, can
be covered by tax-free HSA withdrawals. Moreover, it’s important to
use HSA assets during your own lifetime (and/or that of your
spouse), because the tax benefits effectively cease after your
death; withdrawals by nonspouse beneficiaries are taxed as ordinary
income.
Alternatively, if your high dental expenses happen to coincide with
other major healthcare outlays in a given year, you may be able to
deduct those expenses on your tax return. (Dental expenses can be
bundled with other healthcare outlays from the standpoint of
deductions.) However, you can only deduct medical expenses in excess
of 7.5% of your adjusted gross income. In addition, the higher
standard deduction amounts, plus the new senior deduction, mean that
many older adults will be better off claiming the standard deduction
than they will itemizing.
The bottom line: For people with adequate financial assets, forgoing
insurance and self-funding dental coverage can make sense. It gives
you more control over where you receive dental care.
Additionally, once you factor in insurance premiums and annual caps,
you won’t necessarily be that much ahead with insurance versus
paying out of pocket. Your provider may also offer a discount if
you’re not going through insurance.
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