How to Choose the Best Medicare Advantage Dental Plan

Navigating Medicare Advantage dental plans can be a challenge, especially with so many options and varying levels of coverage. Dental health is essential at any age, but as we grow older, access to quality dental care becomes increasingly important. To make the best choice, it’s important to know what to look for, including coverage options for specific procedures, annual maximums, out-of-pocket costs, and network restrictions. Here at DenScore, we’re committed to helping you find a plan that fits your needs.

Ask for Recommendations and Do Your Research

Choosing the best dental care is not just about coverage—it’s also about comfort and trust in your provider. Before diving into Medicare Advantage plans, ask friends, family, and coworkers for recommendations. Personal experiences can often guide you toward dentists who provide exceptional care and bedside manner. If you need a specialized procedure, like a root canal, it’s also wise to consult a specialist rather than relying on a general dentist. At DenScore, we help you navigate these choices and find quality dental care that meets your needs.

5 Things to Look for in a Medicare Advantage Dental Plan

When comparing Medicare Advantage dental plans, here are the five top factors to consider:

1. Dental Implant Coverage

One of the most crucial aspects of a Medicare Advantage plan with dental benefits is dental implant coverage. For elderly patients, missing teeth can impact quality of life and overall health. Dental implants are often the best solution for replacing missing teeth because they provide a stable and long-lasting replacement. Additionally, if you have a denture or are planning to get one, dental implants can stabilize it, making it more comfortable and functional.

Anthem Blue Cross Blue Shield offers a competitive HMO-POS plan with a $3,400 annual maximum. They cover 50% of dental implant costs when using an in-network provider, which can significantly reduce out-of-pocket expenses for this often pricey procedure. For anyone needing implants, checking if your Medicare Advantage plan includes this type of coverage can make a world of difference.

2. High Annual Maximums

Dental costs can add up quickly, especially for older adults who may require multiple treatments. That’s why it’s important to choose a plan with a high annual maximum. The annual maximum is the cap on how much the plan will pay for covered services each year. Once you hit this limit, you’re responsible for any additional costs out-of-pocket.

Wellcare’s No Premium HMO-POS plan offers a $5,000 annual maximum in some markets, with a $0 co-pay. For those needing extensive dental work, a high annual maximum can prevent significant out-of-pocket costs. When exploring Medicare Advantage options, look for plans that offer a substantial annual maximum, as it will help cover costs if you need extensive dental treatment.

3. Co-Pays and Co-Insurance Costs

While some Medicare Advantage plans may promote high annual maximums, it’s also essential to consider the out-of-pocket costs associated with each visit or procedure. Some plans may have high co-pays or co-insurance for dental treatments, meaning you’ll still end up paying a significant amount despite the coverage.

For instance, Aetna’s Eagle PPO plan balances cost with coverage. It offers a $3,000 annual maximum with $0 co-pay and 0% co-insurance, making it a more affordable choice for members. Having a lower co-pay or co-insurance percentage can make a difference, especially for those needing ongoing care. Plans with low co-pays or co-insurance rates are ideal for minimizing out-of-pocket expenses.

4. Network Restrictions

One important consideration with Medicare Advantage plans is whether they restrict you to a specific network of dentists. Many Medicare Advantage plans require you to see in-network providers for full coverage, while others offer some flexibility with out-of-network options. Network restrictions can impact your ability to choose a dentist or access care conveniently.

The HumanaChoice PPO plan is an example of flexibility in this area. It covers 100% of the cost of covered procedures, whether you see an in-network or out-of-network dentist. With this level of flexibility, you have the freedom to choose a dentist that you feel comfortable with, without the limitations of a network. If having options is important to you, look for plans that either don’t restrict your choices or offer good coverage even when going out-of-network.

5. Cash Benefit or Allowance

Some Medicare Advantage plans go a step further by offering a cash benefit or a prepaid debit card to be used on dental services. While this might not cover more complex procedures like dental implants, having the flexibility to pay for dental care outside of a network can provide more freedom in choosing providers and services.

Devoted Health, for example, offers plans that include a cash benefit, allowing members to choose their dentist and use funds for dental procedures that may not be covered by insurance. A cash allowance is a great option for those who want more control over their dental care or may need to pay for elective services not covered by traditional Medicare Advantage plans.

By evaluating these five factors, you can make an informed decision when choosing a Medicare Advantage plan with the best dental benefits. Whether you need dental implants, a high annual maximum, affordable co-pays, flexible network options, or a cash benefit, the right plan is out there to meet your needs. With DenScore, finding the best Medicare Advantage dental plan has never been easier—get started today and take control of your dental health journey.

DenScore: Your Trusted Dental Navigator for Personalized Solutions

Understand all aspects of dental care with DenScore. Utilize our free online dental navigation tool to get answers if you have questions about pain in your mouth, cosmetic dental procedures, replacement of missing teeth and more. Our care navigators can also assist you in finding the right dentist or dental insurance to ensure you will be able to stay on top of your oral health.