H.R. 9832: Medicare Dental Benefit Act of 2026

This bill would add

Medicare coverage for dental care

starting January 1, 2028. In general, it would make Medicare cover a new category of dental and oral health services, which the Secretary of Health and Human Services would define further by regulation.

The bill says these services would include:

• Routine preventive care, such as dental cleanings, exams, and x-rays
• Basic dental work, such as fillings and extractions
• Major dental work, such as root canals, crowns, and dentures
• Emergency dental care
• Other necessary oral health services

It would also explicitly treat routine diagnostic and preventive dental care as a preventive service under Medicare.

How Medicare would pay

For most covered dental and oral health services, Medicare would pay:

• 0% in the first year the benefit takes effect
• Then the Medicare payment share would rise by 10 percentage points each year for seven years
• By the eighth year and after, Medicare would pay 80% of the allowed amount

For some low-income beneficiaries who qualify for Part D subsidy help, Medicare would pay 80% right away when the benefit begins.

The bill also sets limits and gives the Secretary authority to add more rules. For example:

• Medicare would pay for only two cleanings per year
• Medicare would pay for only two routine exams per year
• The Secretary could require prior authorization or impose other reasonable limits
• The Secretary could waive limits for certain people or groups
• The Secretary could adjust coverage to match recommendations from the U.S. Preventive Services Task Force

Dental prostheses

The bill would also change Medicare rules for dental prostheses, which include items like dentures. It would create a separate Medicare payment rule for these services and generally phase in coverage the same way:

• 0% in the first year
• Then coverage would increase by 10 percentage points per year
• Eventually reaching 80%

For the same low-income group described above, Medicare would pay 80% from the start.

For prostheses, the bill would limit payment to:

• One full upper and one full lower prosthesis every five years
• One partial upper and one partial lower prosthesis every five years

The Secretary could also add prior authorization or other limits, and could waive limits in some cases.

Other Medicare and Medicaid changes

The bill would remove a current Medicare exclusion that prevents certain dental-related services from being covered, and it would make related technical changes so the new dental benefits fit within existing Medicare payment rules.

It would also change Medicaid matching rules so that, when a state pays some Medicare cost-sharing for qualified Medicare beneficiaries and that cost-sharing is tied to the new dental and oral health services, the federal government would pay 100% of that state expense.

Task Force membership

The bill would require the U.S. Preventive Services Task Force to include at least one oral health professional.

Relevant Companies

• HCA Healthcare, Inc. (HCA) — could see increased demand for dental and related outpatient services if Medicare begins covering more oral health care.
• CVS Health Corporation (CVS) — could be indirectly affected through its Medicare Advantage and pharmacy/health services businesses, especially if coverage rules change for beneficiaries.
• UnitedHealth Group Incorporated (UNH) — could be impacted through Medicare Advantage plan design and administration if dental benefits are expanded under Medicare.
• Humana Inc. (HUM) — could be impacted through Medicare Advantage offerings, which often compete on supplemental benefits including dental coverage.
• Cigna Group (CI) — could be affected through Medicare-related insurance and dental benefit administration.
• None found