Medicare Section
DENTAL COVERAGE – What are my options?
I receive a lot of questions about needing dental coverage or insurance from clients who want to know how they can get dental insurance. The subject of dental coverage is a hard one. Even if you can get dental coverage or insurance the amount the dental insurance carriers (companies) cover is minimal. Then you have to use their in-network dentist, which may not include your dentist. Most people don’t want to change their dentist to use an in-network dentist. So what do you do?
Well …. my clients know that most Medicare Advantage plans do come with some dental coverage, like preventive. Preventative coverage is defined as cleanings, xrays, and oral exams only. But want about major restorative coverage which would be the fillings, extractions, dentures, ect.?
For major restorative, here is where you would have to purchase the Medicare Advantage “rider” which cost money. Then the rider might only give you about $1,000 or maybe $1,500 per year worth of dental coverage and only cover about 50% for major restorative services (up to the annual out of pocket of $1,000 or $1,500).
There is one Medicare Advantage PPO plan (for 2022) that will give you $1,000 annual coverage for cleanings and limited coverage for major restorative, and you have to use their in-network dentist. There is another Medicare Advantage PPO plan that will give you $750 annually as a reimbursement and you can see any licensed dentist.
There are some Medicare HMO plans that might offer you more dental coverage annually but then you compromise with HMO plans on having coverage if you treat medically out-of-network. You would end up paying 100% of medical costs if you ended up out of the network (medically).
So you see, they annual coverage for dental is not great but at least it gets you started …. I guess. Here is more information:
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Medicare Advantage Plans: Some Medicare Advantage Plans offer routine dental coverage.
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Medicaid: In some states, Medicaid covers some dental services. You may qualify for Medicaid if you have a low income and minimal assets.
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Private stand-alone dental plans: You can purchase a separate dental plan from a private company.
- I do offer stand-alone dental insurance and you can review the plans and pricing, get a quote, look to see if your dentist participates, and enroll right online from my website. (I will receive a commission for your enrollment). Questions? … please call.
