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Medicare Advantage Dental Plan Benefits

Advantage-dental-plan-benefitsCovered services can include:

  • Oral exams
  • Dental x-rays
  • Diagnostic services
  • Cleanings (prophylaxis)
  • Crowns, bridges
  • Dentures
  • Extractions
  • Restorative services (example, filings)
  • Endodontics (treatment of root canal)
  • Periodontics (gum disease treatment)

One MA Dental Plan Covers – Another Does Not

Not all Medicare Advantage dental plan benefits are equal.  That is important information to know if dental coverage is important to you.  We share some specifics here.  And, below, find some questions to ask when comparing Medicare Advantage plan coverage.

Each MA plan specifies what services are covered. 
There may also be an annual limit on dental coverage, for example, $1,000.
You may have to use a provider within the plan’s network.

Here’s what to look at when comparing plans:

Is my dentist in the plan’s network?  Typically plans provide a listing of dental providers.  However, this may not be provided until after you are a plan participant.  Below we share the recommended wording to use determine if your dentist is covered by the plan.

One Cleaning Or Two?   Some plans may limit you to one cleaning each year.  Others may cover two cleaning, something many dentists recommend.

Do you have more serious and costly dental needs?  Since many need more care at older ages, this is something to seriously ask about.  Take implants.  Most plans do not cover them.  But some will up to $2,000.  Ask about periodontal benefits which are common among seniors.

Is there a ‘cap’ or dollar limit on preventative care?  These include oral exams, dental x-rays, cleaning and even fluoride treatments. Each plan, however, will define specific limits. Most cover 100% of x-rays and cleanings. Some only cover a percentage of the cost for fillings or other services.

Is there a maximum out-of-pocket limit?.   The average annual out-of-pocket limit on dental coverage was $1,300 in 2021. But, more than half of enrollees were in a plan with a maximum benefit of $1,000 or less.  Because some had limits of $500, this is important to check.

Does the plan offer a ‘Buy Up’ option?   MA dental plans can be rather limited. Some plans offer an option to buy added coverage.  This may be valuable if you need costly services like implants, dentures or periodontal work.

Find The Best Advantage Plan For You

Best Medicare Advantage plan

Click here to access the free online directory

The Association provides the only online directory listing independent Medicare insurance agents.

Click the image to the left. Or use the banner on the right-hand side.

Access is 100% private.  You only enter your Zip Code.

You can see agents listed by Zip Code.  Look for those who indicate they help seniors compare Medicare Advantage plans.

You can Email them privately.  Or call.

During Medicare Open Enrollment agents gets very busy.  We suggest you might BOTH email them and follow-up with a phone call.  You do not want to miss the December 7th deadline.

Tip To Find If Your Dentist Is Covered

Best way to determine if your dentist is covered by the plan.  Especially today because, many insurers offer multiple dental plans.  Ask if the dentist ‘accepts the Aetna, or Cigna dental insurance’ may NOT get you an accurate answer.  You must ask if they accept the specific plan (by name).  For example, “do you accept the Cigna Preferred Medicare HMO plan?”

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The American Association for Medicare Supplement Insurance advocates and provides information for seniors on Medicare.  In addition AAMSI hosts the national online directory giving consumers free access to find local independent Medicare insurance agents.