Dental care is important for your health as you get older. Many people choose Medicare Advantage (MA) plans because these plans may include dental coverage. These Medicare plans can help you stay on top of your oral health.
What do I need to know about Medicare Advantage dental benefits?
Medicare Advantage plans may include dental benefits that go beyond Original Medicare coverage. Some plans help cover preventive dental care, network dental services and optional supplemental dental benefits. Reviewing plan details can help you understand what the covered dental services, provider options and potential out-of-pocket costs are.
What dental services are not covered under Original Medicare?
Original Medicare doesn’t cover routine dental services such as:
- Cleanings
- Oral exams
- X-rays
What dental benefits do Medicare Advantage plans offer?
Some plans may include preventive dental care, like:
- Cleanings
- Oral exams
Some plans may also cover more dental services, such as:
- Fillings
- Extractions
Optional Supplemental Benefits (OSB)
A dental Optional Supplemental Benefit (OSB) is extra dental coverage. Some Medicare Advantage plans let you add an OSB to get more dental services. A dental OSB can help cover more services like: Fillings, Crowns, Dentures
When can I add a dental OSB?
You can usually add a dental OSB:
- When you first enroll in your plan
- Within 30 days of your plan's start date or renewal date
- During the Annual Enrollment Period, Open Enrollment Period, or Special Enrollment Period
- To add a dental OSB, you'll need to submit an OSB request form. Log in to the Aetna Health app or your member website to find your plan documents and the form.
Does it cost extra?
- Yes. You'll pay an additional monthly premium for a dental OSB.
- Benefits, costs, and availability vary by plan.
Dental coverage with Aetna Medicare Advantage (MA) plans
Some Medicare Advantage plans include dental coverage through a network of providers.
Seeing a dentist
With many Medicare plans, you may:
- See any licensed dentist in the United States
- Pay less when you see a dentist in the plan’s network
MA plans offer network dental benefits/coverage
For PPO plans, you have the option to go to any licensed dental provider in the U.S. but could save money by using a provider in network.
| Benefit | Coverage |
|---|---|
| Oral exams | Covered |
| Routine cleanings | Covered |
| X-rays | Covered |
| Fillings | Varies by plan |
| Extractions | Varies by plan |
| Teeth whitening | Teeth whitening is a cosmetic service. It's not covered. |
Want to find a dentist in the Aetna Dental PPO Network?
Network dental coverage with Medicare Advantage plans
Some Medicare Advantage plans include a network dental benefit. This means:
- Your plan may cover certain dental services right away
- You may need to use a dentist in the network
- Some PPO and HMO-POS plans may let you see any licensed dentist in the U.S.
- You can still save money by seeing a dentist in network
You can find an in-network dentist through the plan’s provider directory.
Preventive care
Most Medicare Advantage plans cover preventive dental services, like:
- Cleanings
- Exams
- X rays
If you use a network dentist for preventive care, you may pay nothing out of pocket for these services.
Dental care for more complex things
Dental coverage for more involved care may change by plan. This includes:
- Fillings
- Extractions
- Crowns
You may need to pay part of the cost. To pay the lowest amount, see a dentist in the network. Check your plan to learn more.
Plan limits to know
As you review Medicare dental coverage, keep in mind:
- Your plan may limit how many preventive visits you can have each year
- Your plan may have a cap on coverage for comprehensive care
- Not all plans offer full comprehensive dental coverage
Some Aetna Medicare plans don’t include full dental coverage. You can check your plan’s Evidence of Coverage to learn more.
Dental care and your overall health
As you get older, taking care of your teeth is an important part of caring for your whole body. With Medicare Advantage plans, you have options that may help make dental coverage easier and more affordable.
Commonly asked questions about Medicare Advantage dental coverage
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Some Medicare Advantage plans include preventive dental benefits such as routine cleanings, oral exams and X-rays. Using an in-network dentist may help lower your out-of-pocket costs for covered preventive services. Covered dental services can vary by plan.
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Some Medicare Advantage plans already include preventive dental coverage. Certain plans may also include coverage for more comprehensive dental services. Reviewing plan details can help you decide whether you need additional dental coverage.
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Medicare Advantage dental coverage may include preventive services such as cleanings, exams and X-rays. Some plans may also help cover fillings, extractions, crowns and other comprehensive dental services. Coverage, copays and yearly limits can vary by plan.
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Some Medicare Advantage plans help cover major dental services such as crowns, root canals and other restorative dental care. Your costs can depend on the specific service, your plan coverage and whether you use an in-network dentist.
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Some Medicare Advantage plans include yearly limits for certain dental services. Limits can vary based on the type of dental care and the plan you choose. Reviewing plans can help you understand dental benefits, coverage limits and potential out-of-pocket costs.
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Medicare Advantage plans may combine medical, prescription drug and dental coverage into one plan. Standalone dental plans may offer different provider networks, coverage limits or premiums. Comparing costs, covered services and provider access can help you choose the dental coverage that fits your needs and budget.
