Thinking About Dental Coverage? Here’s What You Need to Know

by Natalie Stefan

If you’re exploring Medicare Advantage plans with dental benefits, it’s important to understand what’s covered—and what’s not—before you book that next cleaning.

Most Medicare Advantage plans that include dental coverage offer full benefits for preventive care, including:

  • Routine cleanings
  • Oral exams
  • X-rays

These services are often covered at 100%, especially if you visit a provider within your plan’s network. While some PPO and HMO plans allow you to see any licensed dentist, you’ll typically pay less out-of-pocket by choosing an in-network provider.

What About More Extensive Dental Work?

Coverage for restorative procedures—like fillings, extractions, or crowns—varies significantly by plan. Some may cover a portion of the cost, while others might require higher copays or coinsurance. Always review your plan’s summary of benefits to know exactly what to expect.

Coverage Limits You Should Know

Keep in mind, dental coverage through Medicare Advantage may come with:

  • Annual limits on preventive services
  • Caps on coverage for major procedures
  • Benefit maximums (i.e., the total your plan will pay for dental care each year)

These maximums can range widely, from as little as $10 to as much as $6,000, depending on the plan. It’s crucial to check with your provider so you’re not caught off guard.

Need Help Choosing the Right Dental Plan?

You don’t have to navigate this alone. Medicare Info connects you with licensed Medicare specialists who can walk you through your options and help you find coverage that fits your needs and budget.

Get started today and take the guesswork out of dental coverage.

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