Abstract Since its introduction in 1965, Medicare has included a near-total exclusion for oral health care. Over the subsequent 55 years, both medicine and dentistry have evolved to become more complex, complementary, and overlapping. It is now known that diseases of the oral cavity can adversely affect the success of treatments often covered by Medicare, including heart valve replacements, hematopoietic stem cell transplants, bisphosphonate therapy, and radiation therapy. Orodental disease may also modify chronic disease processes, such as type 2 diabetes and rheumatoid arthritis. Yet, Medicare coverage remains very separate—almost nonexistent—for oral diseases.