Comparing Dental Benefits Included with Medicare Advantage Plans Can Save Seniors Thousands

Jesse Slome
·4 min read

You've undoubtedly seen the television ads promoting free dental benefits available when you call to inquire about the right Medicare plan. It is true that Medicare Advantage plans today typically include some dental benefits. But that's where the similarity ends and the need to compare begins.

Dental care and health care coverage

Dental care is especially important for seniors. According to the Centers for Disease Control, one in five adults 65 or older have untreated tooth decay. Over two thirds (68%) have gum disease. Oral hygiene is an important part of keeping your overall health in shape, but standard health insurance does not include caring for your teeth and mouth in regular coverage.

Medicare and Dental

Medicare does not generally cover dental care. However, Medicare Advantage plans are increasingly beginning to offer Medicare dental benefits. In 2021, some 16.6 million MA plan individual enrollees had access to some dental coverage. Roughly 24 million individuals have Medicare Advantage coverage.

How to find the right Medicare dental plan

When it comes to considering dental benefits, the first point of comparison should be which dentists are covered by a particular plan. Some require the use of dentists who are part of a designated network. Another will allow you to use any dentist you prefer. Simply pay the dentist and submit a claim for reimbursement up to the maximum. In the case of a plan from a leading national insurer, the maximum plan limit for 2022 will be $1,500.

What is covered by most dental MA plans?

Most dental plans included with your Medicare Advantage plan will cover preventive dental services. 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.

Non-routine services such as extractions, periodontic and endodontic services can be quite costly. Some included dental plans do not cover any of these. Others do, even with a $0 copay, although limits may apply and pre-authorization may be required.

Plans generally have maximum out-of-pocket limits. While the average annual limit on dental coverage was $1,300 in 2021, more than half of enrollees were in a plan with a maximum benefit of $1,000 or less. Some had limits of $500.

At older ages, less common dental needs are often essential. Here's where costs can really add up and the differences among plans can be especially important. As an example, most Medicare Advantage dental plans do not cover or pay for implants. If you are prone to needing implants, a plan that does could be a significant money saver. Our research found a plan that reimburses up to $2,000 annually.

Finding The Best Advantage Dental Plan For 2022

Medicare Open Enrollment is the opportunity to find the best Medicare Advantage plan coverage for the coming year. If you have a plan with lackluster dental benefits or have put off more significant dental needs, now is the ideal time to compare.

If you are looking for new Medicare coverage, start by calling your preferred dentist. Ask what dental plans they accept. You must be very specific when it comes to plan names. Many insurers offer a variety of plans, all with very similar sounding names. If you found your current plan's benefits disappointing, it's very likely that better plans exist.

No single source exists that currently compares and helps you identify the best Medicare Advantage dental plans for your area. Comparing Medicare Advantage plans can be complex especially with the Open Enrollment deadline looming. Depending on where you live, there can be between 20 and 40 different plans available. Most do not fully describe covered dental plan benefits and limits on their website.

For that reason, you may want to connect with an experienced local independent Medicare broker who advises seniors about locally available MA plan options. Brokers can be found using the online directory hosted by the American Association for Medicare Supplement Insurance (AAMSI).

While you are doing that, it is vital to also compare your prescription drug plan coverage for the coming year. A simple comparison of the best Medicare drug plans can help you save hundreds and even thousands of dollars in the coming year. A number of online resources will enable you to quickly and easily compare options.

Be prepared to enter information about the prescription medications (drug name and dosage). This very specific information will identify the plan offering the lowest annual premium and the best coverage.

Get covered during Open Enrollment

Once again, don't overlook the fact that Open Enrollment ends December 7th. It's a lot to chew on. But the savings can leave you with a very sweet taste for the coming year.

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