I picked a Medicare Advantage plan because of the dental and now I found out it only covers cleanings. Why didn't anyone tell me this upfront?
Answered by 22 licensed agents
Most Medicare advantages cover more than cleanings. If you worked with a broker you needed to ask them how the dental works and what they will Cover. You can also call me and I can advise
That’s all on the agent. You should’ve been told that up front. I’m very sorry you had that happen to you. Bottom line, a good agent makes sure you know things like that.
I'm sorry to hear your expectations weren't met by your plan. The best way to prevent this issue is to look at the Summary of Benefits or the Evidence of Coverage. Your agent should have gone over this information with you. I recommend you get a new agent who will go over all benefits during sign up.
Medicare agents are supposed to go over all the details of the plan and make sure you understand it before you sign up. Sometimes when an agent goes over the plan details it can be draining on the brain because of all the numbers you go over. I would talk to your agent and see if there is another plan option that would work for you or if you can add dental for a fee with your plan.
Almost all Medicare Advantage plans cover more than just cleanings. I would recommend you sit down with your agent and have them explain the benefits and details for your dental coverage.
It looks like someone didn't read the full summary of benefits. They could've just been trying to put you on a plan, or possibly you only wanted one with the most dental allowance. If you went through an agent they should've told you, and you should have been clear on your expectations.
Medicare Advantage Plans vary. That’s why it is important to make sure the agent that you are working with is contracted with every carrier in your area; so that you get the absolute best plan to fit your needs. If an agent is not contracted and certified with each carrier in your area then you are not getting to see every plan on the market, they can only write the plans that they are contracted with. If you are trying to navigate all the plans in your area online by yourself then it’s hard to review that many plans by yourself. I am so sorry you didn’t get the plan with the benefits that you wanted and needed.
I highly recommend shopping for a local agent and then ask them how many carriers they are contracted with. If it’s only one or two, you will want to keep looking for an agent that has at least 5 or more carriers that they represent. And make sure that agent does a detailed review of your doctors, medications, and the plans benefits and make sure they know what other extra benefits are of importance to you like the dental and vision.
Apparently you didn’t interview my recommended minimum of 2-3 agents at age 65. If you had, you’d have gotten an overall review of the entire system & you would not be in this situation. If you are still in your 65th year, exercise your “Trial Right” and purchase a Med Supplement and a DVH policy (Dental/Vision/Hearing) which shows how much $$$ will be reimbursed to you for all treatments. Your current agent must be replaced, she/he is a probably too new to the Medicare wars.
Most Medicare Advantage plans cover more than just cleanings. This is something that your broker or agent should have gone over with you. Your plan's summary of benefits should also provide more details as to what your plan will and will not cover.
As an insurance broker, I always discuss the benefits of my clients' plans or any plans I recommend. You should be able to call your agent/broker and have them clarify, or you can contact me, and I will be happy to review it with you.
You should have been told. If you worked with a broker, you may call them up and let them know you’re unhappy and feel shorted. Advantage plans do change benefits a year as well. I would treat this as a learning curve and in the future whenever you look at an advantage plan Be sure to ask specifics When it comes to dental.
Every year the coverages can change therefore it's important to review your Annual Notice of Change from your insurance company. This comes in September before Annual Enrollment Period from 10/15-12/7 for the upcoming Jan 1st benefit period. Working with a trusted agent who isn't too busy to answer questions is helpful
Medicare Advantage plans may offer dental coverage, but coverage varies by plan.
Dental services included in these plans can range from basic cleanings to more extensive procedures.
It’s important to review each plan’s specific dental benefits and any associated costs carefully.
Understanding Medicare Advantage
Medicare Advantage, also known as Medicare Part C, is an alternative way to receiving Original Medicare (Part A and Part B) benefits.
These plans are offered by private insurance companies approved by Medicare and provide all the same coverage of Original Medicare, and often additional benefits like prescription drug coverage, dental, vision, and hearing services.
Medicare Advantage plans may be an attractive option for individuals looking for additional healthcare coverage and often come with different plan types, network restrictions, and cost structures to suit your individual needs.
If you had a broker that was good, they would have explained all of this to you. Once again, its important to not only find an Independent Agent, but one that ONLY does Medicare. You can't be an expert at everything and if the agent does multiple lines of insurance, they cannot be an expert at Medicare, there's just not enough hours in the day to stay current.
My response would be, did you enroll using a telemarking agent? Or did you enroll in person with a licensed and experienced health insurance agent who specializes in Medicare plans? Either way, they are required by law to go through the full summary of benefits of the plan. My point is, you always want to do an in-person enrollment with an agent, where you are given the booklet of the plan and can thoroughly go through all the benefit details. At this point, you can lodge a complaint against the agent with both the plan and CMS (Medicare).
Depends on the plan you choose but for the most part most carriers will offer a maximum annual benefit of $1500 on all procedures however depending on the procedure, you will still have out of pocket expenses. With a Medicare Advantage plan you can pick up a second stand alone Dental plan to cover the lion share but these plans are very limited on what they will allow for implants. Some of my friends go to Mexico and pay much less without insurance.
Hard to truly explain why someone would fail to explain that, but ultimately it falls on the agent who helped you with the enrollment. Currently we're not within an eligible enrollment period to make a change to something more appropriate but you could easily add a low cost dental plan to help you through the remainder of the year until you can review your plan options for next year.
Totally understandable—and you’re not alone in feeling frustrated. Many plans advertise “dental included,” but the fine print often just covers cleanings, maybe X-rays. Stuff like fillings, crowns, or dentures? That’s usually extra or not covered at all.
Unfortunately, unless someone breaks it down for you, it’s easy to assume it covers more than it does. It’s always good to ask for the full dental breakdown before signing up—but I get it, it should be way clearer up front.
Im so sorry you had that experience! Its always important to review not only the brochure carefully, but if working with an agent, have a list of things you are specifically looking for in your plan to ask the agent. You can't plan for everything so do the best you can. And do you know that from Jan 1 to March 31, you can change to another medicare advantage plan ? So use those 3 months to " test drive" a plan.. see your dr, scout out dental and other providers ... if you have problems you can't resolve, then find another plan. You can change it once during that time.
I’m sorry to hear you’re feeling frustrated about your Medicare Advantage plan’s dental coverage—it’s totally understandable to expect more clarity upfront. As a Medicare agent, I didn’t help you pick this plan, but I’m happy to shed some light on what might’ve happened. Dental benefits in Medicare Advantage plans can vary a ton, and sometimes the details get buried in the fine print. A lot of plans advertise “dental coverage” to draw folks in, but they might only cover basics like cleanings and exams, not bigger stuff like fillings or crowns. It’s possible the plan’s summary highlighted the dental perk without spelling out the limits, and unless someone walked you through the Evidence of Coverage document, those specifics can slip by. I’d love to help you review your plan now—maybe we can find a better fit for next enrollment if you need more than cleanings.
Sometimes agents don't really listen to their clients, and the client ends up with only part of what they are trying to express to the agent what their needs are. That is why I pride myself in forming a relationship with my client so that I can understand what they need and are looking for.
That is unfortunate! Not sure why that wouldn't have been explained. Sometimes plans will allow for comprehensive dental services as an add-on or rider to the policy at an extra cost. If in a bind for this calendar year and needing more dental coverage, there are stand alone dental plans that can provide comprehensive services that you can get set up on without having to wait for an enrollment period.
