Do Medicare Advantage Plans cover Dental Services?

Regular checkups can even catch other health issues early, like oral cancer. 

So it’s no surprise that a common question many people have as they look at health insurance plans is, "What dental services do Medicare Advantage plans cover?"  

Knowing what's included in Medicare Advantage plans can help you make smart choices and keep your dental health in check without unexpected surprises. 
 

Understanding Medicare Advantage Plans and Dental Coverage

Medicare Advantage plans, also known as Medicare Part C, are an alternative to Original Medicare alone. These plans are offered by private insurance companies and provide the same coverage as Original Medicare (Parts A and B) while including additional benefits such as vision, hearing, and dental care. The inclusion of dental coverage is a significant advantage for many seniors, as Original Medicare does not generally cover routine dental services.

The scope of dental coverage in Medicare Advantage plans can vary widely depending on the specific plan and insurance carrier. While some plans offer only basic preventive services, others may include more comprehensive dental care. Understanding what each plan covers is important to ensure your dental health needs are fully addressed.

 

What Dental Services are Covered by Medicare Advantage Plans

The dental coverage provided by Medicare Advantage plans generally focuses on preventive care and basic dental services. 

Here are three routine services you can generally expect to be covered:

1. Routine Dental Exams: These regular check-ups are vital for maintaining oral health and detecting potential problems early. Some Medicare Advantage plans cover one or two dental exams per year.
2. Teeth Cleanings: Professional cleanings are essential for removing plaque and tartar buildup, helping to prevent gum disease and tooth decay. Plans often cover cleanings once or twice a year.
3. X-rays: Diagnostic X-rays are a standard part of dental care, allowing your dentist to identify issues that may not be visible during a routine exam. Most plans cover X-rays, though the frequency may vary.

While preventive and basic services are generally covered, all plans may not fully include more extensive dental procedures. For example, coverage for crowns, bridges, root canals, and dentures may be limited or require additional out-of-pocket costs. Some plans offer dental coverage for these services, so it’s important to review the specifics of each plan carefully.

 

Additional Dental Benefits

Beyond the standard dental services, some Medicare Advantage plans may offer additional benefits to enhance your dental care. These can include:

• Allowances: Plans may offer additional dental allowances for dental work outside of what is covered or prescription drugs related to dental services and procedures.
• Comprehensive Dental Coverage: Some plans go beyond the basics, covering more extensive dental procedures like crowns, implants, and orthodontics. If you anticipate needing major dental work, this type of coverage could be beneficial.
• Access to a Wide Network of Dentists: Medicare Advantage plans often have established networks of dental providers. Choosing a plan with a large, accessible network ensures you can find a dentist who meets your needs.
• Annual Maximums: Plans typically have an annual maximum amount it will pay for dental services. Some plans offer higher maximums, which can be particularly valuable if you require extensive dental care throughout the year.

When evaluating Medicare Advantage plans, consider these additional benefits, especially if you anticipate needing more extensive dental care in the future.
 

Choosing the Right Medicare Advantage Plan

Selecting the right Medicare Advantage plan requires careful consideration of your dental health needs. Here are a few tips to help you choose the best plan:

• Review Coverage Details: Start by comparing the dental coverage options offered by different plans. Look for plans that include the services you’re most likely to need.
• Evaluate the Provider Network: Ensure the plan has a network of dental providers that is convenient and includes dentists who meet your standards.
• Compare Costs: Consider the premiums, copayments, and annual maximums associated with each plan. Some plans might have lower premiums but higher out-of-pocket costs for dental services.
• Consider Additional Benefits: If you expect to need more extensive dental care, look for plans offering comprehensive dental coverage or discount programs. These could provide significant savings in the long run.

By taking the time to understand your options and compare plans, you can select a Medicare Advantage plan that offers the dental coverage you need. This will help ensure your oral health is well-supported as you enjoy your retirement years.

At Clover Health, some of our plans offer allowances for dental services. If you live in New Jersey, Georgia, Pennsylvania, South Carolina, or Texas, you can find a Clover Health Medicare Advantage Plan and view our dental benefits.