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 68 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
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.
The person who enrolled you should have gone over all the benefits with you in detail; you still may be able to change plans before. March 31st, and get a plan that covers more dental
If an agent or a broker helped you enroll, they should have told you about all of the benefits included with the plan. If they knew that dental was one of your main concerns, then that should have been one of the main benefits they addressed. If, on the other hand, you called an 800 number from the T.V. than you may have been rushed through the process and were given incomplete information. Any plan you are enrolled in should be discussed completely. There should be no surprises when you use your plan.
The Summary of Benefits and Evidence of Coverage, which is mailed to the enrollee reviews all coverages. From Jan 1 to March 31, you can make one plan to plan change if a different plan better meets your needs.
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.
Medicare Advantage plan benefits can change every year. Some plans have preventative only, some have comprehensive coverage and some plans don’t have any dental coverage at all. Original Medicare doesn’t cover dental, and MA plans sometimes do. If you had a Broker help you with your enrollment, he/she would’ve been able to send you and talk through those details. I’m sorry you didn’t realize the way your dental was covered. That’s frustrating.
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.
Plans change every year. If this was the case when you signed up then the agent didn't inform you well. If it changed after you signed up, it is important to do an annual review with your Medicare agent to stay informed.
Some plans do include comprehensive dental, although they all used to. If it is important to you we recommend delta dental as a separate policy.
Sadly, unless you're dealing with a good agent that cares more about his clients than his commission, you are your best advocate. Some agents, whether independent or captive to a specific company, are only concerned with getting someone to sign up. While they should care enough about the person to share all of the important details of the plan, they shortcut things to "get a sale" and leave those types of details out of the conversation.
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.
With Medicare Advantage plans or Part C, it is difficult when there are generalizations that the plans include dental coverage. It is really important to know what coverage is included with each of the plans. Worse yet, over the years, the high profile celebrities come in and advertise "free" benefits and may share details that licensed, appointed and certified agents cannot and many would not say that are advertised on T.V. Although there have been attempts at regulating what is advertised on T.V., it is important to identify and understand the details of the plans according to the Plan ID.
Medicare itself does not include dental coverage. It is considered to be a value added benefit. It can be added to Part C or Medicare Advantage plans. Insurance carriers can choose to offer discount coverage which many do not consider true dental coverage, or can offer just preventative or basic coverage, and some opt to include more comprehensive coverage.
The "Evidence of Coverage" will reveal the details of the coverage which can be found on the insurance carriers website, Medicare.gov, and agents should be able to provide or send the evidence of coverage or summary of benefits documents that will outline the coverage.
As legislation has changed and insurance carriers evaluate utilization and rising healthcare costs, insurance carriers have had to adjust what benefits can be offered or have had to place maximum limits for items such as dental as well as vision and hearing coverage that may be added to plans. The Value Based Insurance Designs are sunsetting at the end of 2025 that were instituted in 2017. This has prompted insurance carriers to reevaluate benefits that may be included in the plans.
Because the line scum who sold it to you was only interested in the first year commission that they would get. Not in taking care of you. And you were drawn to all the free bells and whistles not thinking about making a long-term decision about what medical plan would be best for your future.
Ask some people who have parents in the hospital, how much trouble they have with the hospital administrators, wanting to kick their elderly parents out of the hospital because the disadvantage plan won’t approve what is truly needed.
Some Medicare Advantage plans cover more than just cleanings. You chose the wrong one, but your agent should have told you its limitations. The ones that cover more do not cover implants or teeth whitening, but they do cover everything else to their dollar limit for the year.
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.
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.
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.
Depending upon how you enrolled into your Medicare Advantage plan, it is important to understand what is required of the individual assisting you with your Medicare Advantage plan enrollment. When I sit with a Medicare beneficiary, it is required that I discuss the Summary of Benefits (SOB) for the particular plan they have chosen to enroll into for their coverage. The SOB is a multiple page document which details the benefits and costs associated with the Medicare Advantage plan. Within the SOB it details if there is dental coverage and what the dental benefit consists of for that plan.
I'm sorry that happened to you. There are many different Medicare Advantage plans with different dental benefits. It's important to work with a Medicare professional that represents multiple Medicare insurance carriers, to ensure you're getting a plan the meets your needs and budget. Fortunately, the Annual Enrollment Period (AEP) will be her soon (October 15th - December 7th). During the AEP, you can review different plans and make changes.
Unfortunately I’m not sure why the person who signed you up to the plan didn’t give you the benefit breakdown. Each plan covers things differently. I would encourage you to have the plan reviewed by a broker that is able to compare multiple insurance carriers. I would love to help.
My first question is "Who did you talk to?" Did you enroll online by yourself? Did you call the company directly and speak to a sales agent? Did you talk to an independent agent? If you enrolled online, the plan provides what's called a "Summary of Benefits" that lays out all of the plans benefits and costs. You would've been able to read it when enrolling. If you spoke to a sales rep, whether through a carrier or independent, they should have gone over that with you.
I don't know why nobody told you all of the details regarding the dental coverage for the Medicare Advantage plan you enrolled in. Some agents are more thorough than others. Some agents just want to get people enrolled in a plan as quickly as possible so they can move on to the next enrollment. Some customers assume there is more coverage, and don't ask questions to confirm the full extent of benefit coverage. I don't know what the situation was for you personally.
I do know dental is important to most of the people I meet with. Some plans include comprehensive dental while other plans just include preventative--cleanings, xray and exams. I always make sure my clients know what to expect from the dental benefits included in the plans I sell.
I'm sorry you weren't fully informed about the dental coverage included in the plan you chose.
My best advice is--buyer beware. Make sure you ask what dental covers and then ask to see the dental coverage in printed form. The more information you have, the better choice you will make for yourself.
The good news is: If you are not happy with the Medicare Advantage plan that you enrolled in during the Annual Enrollment Period - Oct 15th - Dec 7th, you still have an opportunity to make a one time change from one Medicare Advantage plan to another Medicare Advantage plan. You can make another choice between Jan 1 and March 31st.
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.
That happens more often than you’d think. Many people assume “dental coverage” means everything, but most Medicare Advantage dental benefits are limited, often just preventive care like cleanings, exams, and X-rays.
Agents or plan materials should disclose this, but sometimes the details are easy to miss in brochures or summaries. It’s always a good idea to check the Summary of Benefits or ask specifically about restorative or major services before enrolling.
AT the time of your appointment, you should have been explained the extra benefits after the summary of benefits was discussed, but this is up to the agent to disclose to you upon your request. We are trained to cover the Benefits per CMS guidelines.
The best thing is to have a face-to-face appointment with a local agent, not to enroll over the phone with a telemarketer, unless you enroll with a local agent.
That is the difference between having a good agent and a bad agent. Your agent should have read you and or shown you the summary of benefits, which gives you the details of your plan. Once again, this goes back to not having a good needs assessment. You need to ask questions: how much is my coverage, and what does it cover? I don't think people put value in having a good agent. That person gets paid every year for your renewal. Why are you paying that person? I am so sorry that happened to you. That is part of the reason I want to be a Medicare agent: to help and protect those who need a helping hand. Call me Lea Vollmer
What I can honestly say is.. if you picked Advantage plan because of the Dental you did not talk to me. Medicare does not cover dental and it is an added benefit by carriers. When times are tough and carriers need to scale back they cut your benefits first. You should not enroll into a Medicare plan based on a benefit. Should you talk to an agent that leads with benefits, they are trying to sell you. When you talk to someone curious about your health needs and requirements they will find a plan to fit those needs first, and sweeten the deal with the benefits. TV watchers beware. They lead with benefits as a hook, and this may cause someone to enroll in a plan not suited for their specific needs.
Mi will bet you signed up with the company direct and not an agent. It's more likely that an agent will go over ALL details whether you ask about them or not. As an agent - I go over ALL basics of plan. Contact me
I apologize that the agent did not clearly explain that some Medicare Advantage plans only cover dental cleanings.
Since open enrollment is still available, you do have the option to change your Medicare Advantage plan to another company that may offer additional dental services.
The details should be in the Summary of Benefits and your agent should have reviewed this with you. Sometimes those details are overlooked. You can always purchase a separate dental plan, there are many available. You just missed the Open Enrollment Period Jan 1 - March 31 to make any changes so you will have to wait until October 15 - December 7, which is the Annual Enrollment Period.
Thank you for your submitted question. All features, benefits and copays associated with your Medicare Advantage plan selection should have been disclosed upfront by your agent before selecting a plan. Most Medicare Advantage plans have preventative dental, but not all plan cover comprehensive dental. Fortunately, you still have time until the AEP deadline of 12/7 to change your plan and find one that fits your needs. We are happy to discuss and review your options.
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.
It's frustrating to discover that your Medicare Advantage plan's dental coverage is not as comprehensive as you expected, However, the specifics of these benefits can vary significantly between plans and often have limitations
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).
Your experience can be frustrating because many Medicare Advantage plans include dental benefits as a key selling point. It's hard for me to comment if you had been told the plan includes dental by your agent or they may not have fully explained the specific limitations. In other cases, the restrictions might have been in the plan materials, but were not obvious. If you did not use an agent, you may not have seen what was covered under dental and what wasn't. In any event, since it is the Annual Enrollment Period right now you can make a change and find a plan that fits your needs.
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.
If you did this without the use of a licensed broker you should have read all of the information. If you did this with an agent, the agent apparently glossed over your concern. You have an opportunity to change from Jan 1 - Mar 31.
Brokers Make a Difference. Everyone should use a local competent Broker/agent who represent quality plans in your area. They will be able to help find a plan that will meet your requirements.
All agents should review the details of the Medicare Advantage plans before sign-up. My recommendation is to reach out to a knowledgeable local agent and seek their counsel. There may be other options available, depending on your state and the specific rules in that state. I'm happy to help if needed! Contact me.
If you had an agent helping you then it definitely should have been reviewed with you. It’s the agents job to go over all benefits so you can make a decision to get coverage that meets your needs.
That would be the fault of your agent. Not all agents do what they are supposed to do. There is no way to fix this but do it right. Several of the plans reduced dental last October.
When you talk to me, I do a plan comparison between the top three plans in your area. We compare all the benefits and costs in the plan. I then look for your medications and doctors to ensure they are in your plan's network. Once we pick the plan that is best for you, we go through the plan line by line to make sure you understand it and agree to it.
I also offer Dental Plans separate from your Medicare. One plan gives $5000 per year coverage for about $41 a month.
When selecting a Medicare Advantage plan, it is crucial to review the specific dental benefits outlined in the plan's Summary of Benefits. This document will detail what services are covered, any associated costs, and whether there are annual limits on coverage.
I don't know why you weren't aware of this before buying the plan. There is a lot of information discussed by your agent, perhaps you or they missed it. He should have left you a book with the plan details of your new plan. Always go through that before purchasing any plan and ask about the details line by line. I'm sorry if you were not informed.
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.
I am sorry to hear that your experience has not met your expectations. I am assuming that you had a broker or an agent that helped you with this decision or did you give it your best shot and pick this plan on your own? I would need to know the answer to that question to be able to help you the best.
Of course I do not know who you spoke with, but if you did speak with someone like an agent they should have gone over what the dental plan covered via the Summary of Benefits. As agents we know that all plans are not the same and that we need to review the summary to determine whether you will have comprehensive coverage or only preventative services which only includes cleanings, exams and X-rays. More comprehensive coverage should include fillings, root canals, dentures, etc. All plans vary and with most dental plans you will more than likely have out-of-pocket costs such as a deductible, copays or coinsurance.
If you want more dental coverage you can certainly change your Medicare Advantage plan to something that is more beneficial to you during the Annual Enrollment Period which starts October 15th and runs till December 7, 2025, which is only 3 months away.
I completely understand your frustration, and you're not alone-this happens more often than it should. Many Medicare Advantage plans advertise "dental coverage," but it's important to know that the scope of coverage can vary significantly between plans.
Some plans include only preventive services, like cleanings, exams, and X-rays, while others mav offer comprehensive coverage that includes fillings, extractions, or dentures-but often with limits, waiting periods, or network restrictions.
This is exactly why reviewing the Summary of Benefits and Evidence of Coverage (EOC)
before enrolling is so important—and why I always make sure my clients
understand what's included and what's not, especially when it comes to extras like dental, vision, and hearing.
If you'd like, l'd be happy to review your current plan with you and see if there's a better option during the next enrollment period that aligns with your needs.
Many Advantage plans advertise dental, but most only include basic cleanings and exams. It’s a common misunderstanding, which is why working with an agent to review the full summary of benefits before enrolling can help you avoid surprises like this.
The agent that helped signed you up should have gone through that information to help you make a wise decision if that Medicare Advantage plan would meet your needs. There are a few options, you can possibly switch to a different Medicare Advantage plan and a broker should be able to help you see if that is an option. You can get a stand alone dental plan and sign up for those anytime of year. That is an option to you can have comprehensive dental, but it would cost a premium to have one of those.
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.
I'm general, Medicare will cover all regular cleanings, x-rays, etc. You and your agent should compare several carriers and note which have additional monies for additional services.
There are ancillary products, for a small fee, that will help cover expenses.
Point blank! Most agents do a terrible job going over the benefits of a Medicare Advantage plan. Most are only interested in making a sale. Also do not buy this product over the phone. So many do and they get burned. The Medicare Advantage plan does send you an outline of coverage but most never read it.
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
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.
If you worked with an agent, the agent should have gone over the plan with you in detail before you enrolled, and you should have been provided with a copy of the plan benefits. These are CMS (Centers for Medicare and Medicaid Services) requirements. If you enrolled on your own, then how much you know about the plan details really depends on your research.
I can't speak to this directly because I don't know how you enrolled (over the phone or in-person), nor with whom you enrolled. However, I can tell you this, in order to remain compliant with Medicare, it is the agent's responsibility to go through the entire summary of benefits with you and point out all of the copays and benefit amounts for each item. Then, the agent should ask if you have any questions and whether you understand the plan benefits as outlined. It is your responsibility to follow along; ask for clarification on any point you don't understand and acknowledge the fact that you understand and would like to enroll in that particular plan.
Did you enroll in the plan yourself or did an agent help you? If you enrolled yourself then you did not read enough about the dental benefits to understand what was covered. If an agent helped you enroll he or she should have explained the dental benefit in more detail and he or she did you a disservice.
Make sure to use a local agent that you trust when making any Medicare plan decisions. You may be eligible for a special enrollment period (SEP) to change plans.
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.
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.
