Medicare Dental Insurance for Seniors: Understanding Coverage and Services

Original Medicare, also known as Medicare Part A and Part B, does not cover most dental care services, including routine cleanings, fillings, and extractions.

However, Medicare Advantage plans, which are offered by private insurance companies, often include dental coverage as part of their package.

Some Medicare Advantage plans may offer additional coverage for dental services, such as dentures, crowns, and bridges, but it's essential to check your plan's details to see what's included.

Recommended read: What's the Difference between Medicare Supplement and Advantage Plans

Medicare dental insurance for seniors can be a bit overwhelming, but don't worry, I've got you covered. AARP/UnitedHealthcare offers a Medicare Advantage plan that has a large network of dentists.

If you're on a tight budget, Aetna is a great option for low-cost dental coverage. This plan can provide you with peace of mind knowing you have affordable dental care.

If you need dental care right away, Humana's standalone plan can provide comprehensive benefits starting the first day of coverage.

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There are two main types of Medicare dental insurance plans for seniors.

AARP/UnitedHealthcare, Aetna, and Highmark offer Medicare Advantage plans with dental coverage, which can include low-cost or free preventative services.

You can choose your dental coverage options during the plan selection process if you're signing up for a new Medicare Advantage plan.

If you're already enrolled in Medicare Advantage, talk to your provider about what dental coverage options are available to you.

Aetna's Medicare Advantage plan is a great option if you need major dental services, as it reimburses you for in-network dental coverage and offers expanded dental benefits at an extra monthly cost.

Standalone dental plans are another option for seniors who only have Original Medicare or a Medicare Supplement plan.

DentaQuest, Aetna, and Humana offer standalone dental plans, which can be purchased directly from an insurance company or through an agent.

Basic standalone dental plans cost around $10 or $15 per month, but may not cover major services until you've had the policy for several months.

Humana is a great option if you need dental care immediately, as most of its plans have no waiting period for major services.

Additional reading: Switching from Medicare Advantage to Medicare Supplement

Medicare Advantage plans typically cover a range of dental services, but the specifics can vary depending on the plan and coverage level.

Routine services such as oral exams, cleanings, X-rays, and fluoride treatments are often included in Medicare Advantage plans.

Basic restorative services like fillings, root canals, and periodontal care are usually covered as well.

Major restorative procedures including crowns, bridges, dentures, and implants are also typically covered by Medicare Advantage plans.

Here's a breakdown of the types of dental services that are usually covered by Medicare Advantage plans:

UnitedHealthcare has the largest network of dental providers of all Medicare Advantage companies, with more than 100,000 providers, making it easier to find a dentist who takes your insurance.

Cigna plans are low-cost, with nearly every plan offering comprehensive dental coverage, including coverage for endodontics, extractions, and restorative services.

UnitedHealthcare's comprehensive dental coverage includes an average of nearly seven services per plan, with standard plans offering $0 copays for preventive dental coverage.

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Cigna's comprehensive dental coverage includes an average of seven covered services, with 90% of comprehensive dental services from in-network providers coming with a $0 copay.

Humana offers plans with Part B Giveback benefits in 48 states and Washington D.C., which means those plans cover a portion of your Medicare Part B premium.

Here are some key facts about the insurance providers mentioned:

UnitedHealthcare is a well-established insurance provider with a large network of providers. They offer Medicare Advantage plans in 49 states and Washington, D.C.

Their plans have the largest Medicare Advantage medical network, with over 1 million providers. This can be a big plus if you have a preferred doctor or specialist.

UnitedHealthcare also has the largest Medicare Advantage dental network, with over 100,000 providers. This means you may have an easier time finding a dentist who takes your insurance.

However, member experience scores are only average, which may be a concern for some. It's essential to research and read reviews to get a better understanding of their plans.

Here are some key facts about UnitedHealthcare's dental coverage:

Cigna offers a wide range of benefits, including 24/7 telehealth and meal delivery after a hospital stay.

Eight in 10 Cigna Medicare Advantage plans have a $0 premium, making it a great option for those on a budget.

Cigna plans are available in only 29 states and Washington, D.C., so be sure to check if it's available in your area.

All Cigna Medicare Advantage members have preventive dental coverage, and 99% have comprehensive dental coverage.

The average Cigna dental plan with comprehensive coverage includes seven covered services, such as diagnostic services, periodontics, and restorative services.

Ninety percent of comprehensive dental services from in-network providers come with a $0 copay, making it a cost-effective option for dental care.

Cigna's comprehensive dental coverage includes an average of seven covered services, including endodontics, extractions, and restorative services.

Here are some of the services that may be covered under Cigna's comprehensive dental plan:

Aetna is a reputable insurance provider with Medicare Advantage plans available in 44 states and Washington, D.C.

Their plans are highly rated, with nearly 8 in 10 Aetna plans earning 4 stars or higher.

You can access MinuteClinic locations for low copays on some plans, making it convenient for primary care needs.

However, customer satisfaction numbers land below the industry average in some major Medicare markets.

Aetna offers comprehensive dental services with 94% of in-network procedures coming with a $0 copay.

In-network preventive dental services, including cleanings, X-rays, and exams, are covered at 100% on all plans.

If you go out-of-network for comprehensive dental services, you can expect to pay coinsurance between 20% and 70% for most procedures.

Here are some key benefits of Aetna Medicare Advantage plans:

Aetna is also the fourth-largest provider of Medicare Advantage plans, offering $0-premium plans to 83% of Medicare beneficiaries.

Devoted Health offers Medicare Advantage plans in 20 states, making it a relatively new player in the market. Its plans are available in a limited number of areas, so it's essential to check if they cover your location.

Devoted Health has above-average star ratings from CMS, indicating a high level of quality in their plans. This is a significant advantage for consumers looking for reliable insurance providers.

All of Devoted Health's plans offer both preventive and comprehensive dental coverage, with an average of more than six comprehensive services per plan. This is a notable benefit for those who value dental care.

Devoted Health's plans are known for their low cost, with most offering a $0 premium. This can be a significant cost savings for consumers.

Here are some key facts about Devoted Health's plans:

Medicare Advantage plans with dental benefits can vary in cost, with some requiring a copay or coinsurance for every service, and others offering a $0 copay for in-network services.

To find the best plan for you, check the star ratings, which are assigned by the CMS based on member surveys, plan data, and medical provider feedback. The star rating is on a scale of 1 to 5, with 5 being the best.

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Compare out-of-pocket costs, including monthly premiums and maximum out-of-pocket costs, which can help you estimate your total expenses for the year. Make sure to investigate how each plan covers your medications, as this can impact your overall cost.

The average annual dollar limit on dental coverage for plans with more comprehensive benefits is $1,300, according to KFF. It's essential to read a plan's Evidence of Coverage to understand the limits on dental coverage.

Here are some tips for shopping for Medicare Advantage plans with dental benefits:

The cost of Medicare Advantage dental insurance can vary widely depending on the plan and service. Some plans require a copay or coinsurance for every service, while others may have a $0 copay for in-network providers but require coinsurance or aren't covered for out-of-network services.

A $0 copay doesn't always mean free, though - some plans may have a dollar limit on what they'll cover. For example, a plan might have a $1,000 annual maximum benefit for preventive or comprehensive services.

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The average annual dollar limit on coverage for people enrolled in plans with more comprehensive dental benefits is $1,300, according to KFF, a health policy nonprofit. This can give you an idea of what to expect from your plan.

You can choose your dental coverage options during the plan selection process, or talk to your provider about what options are available if you're already enrolled in Medicare Advantage. If there is no add-on coverage available, you may be able to enroll in a standalone dental policy.

AARP/UnitedHealthcare, Aetna, and Highmark are among the best Medicare Advantage plans for dental coverage, with Aetna offering cheap monthly costs and the option for expanded dental benefits at an extra monthly cost.

Medicare Advantage plans have star ratings, with 5 being the best, based on member surveys and other data. You can check these ratings to compare plans.

You'll also want to compare out-of-pocket costs, including monthly premiums and maximum out-of-pocket costs, which can vary widely between plans. For example, some plans may have a $0 monthly premium, while others may have a higher premium.

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To ensure your medications are covered, investigate each plan's medication coverage and cost-sharing requirements. This is especially important if you take prescription medications regularly.

If you have a list of preferred doctors and medical facilities, look for plans that include them in their network. This can make a big difference in your overall healthcare experience.

Consider the type of plan that best fits your needs. If you see specialists frequently, a PPO plan may be a better fit. If you're a light healthcare user, an HMO plan might be more affordable.

Here are some key things to keep in mind when comparing Medicare Advantage plans:

Remember, you can sign up for a Medicare Advantage plan during your initial enrollment period or during designated annual enrollment periods, such as Medicare open enrollment in the fall and Medicare Advantage open enrollment in the spring.