My Medicare Advantage plan covers dental, but I can't find a dentist who accepts it. Is this a common problem?
Answered by 10 licensed agents
Yes, not all plans use the same carrier for dental, and some differ between HMO and PPO. However they all have a provider search tool that we can assist with.
Your agent should have checked to see that you plan covered your doctors and dentist before you sign up for that plan
Answered by Bruce Kern on April 18, 2025
Broker Licensed in NJ, AZ, CO & 13 other states
This can definitely be a major frustration! Your dentist should be checked ahead of enrolling in the plan as part of ensuring everyone you see is in network, if your dentist does not take any insurance you can pay them up front and submit a claim for reimbursement to your Medicare Advantage carrier for them to pay you back.
Answered by William Pierce on April 22, 2025
Agent Licensed in IA, MO & NE
Yes it is. As they say...the devil is in the detail. When a Medicare Advantage Plan offers "dental" coverage, it can mean a lot of things. Is it "first dollar dental", meaning that you have a pot of money to draw from, usually without having to pay anything first. Is there a "network" associated with the dental coverage offered. Is it an HMO dental plan or PPO? If you have a good Independent Broker, they know things like this.
Answered by Steve Brauer on April 8, 2025
Broker Licensed in AZ & CA
Depends on who youre with. My suggestion is to find out who your dentist and Dr take. See if you can replace it when open enrollment comes up. There are some discount dental plans you can use during the meantime
Answered by Mike Henry on April 18, 2025
Agent Licensed in TX
That does not happen often! Simply call Customer Service on the back of your advantage plan Wallet card, and the carrier will help you find providers… Once in a while I’ve run into a similar problem, but the Insurance companies have additional resources and provider lists that they can point you to!
Answered by Ross Landon on April 21, 2025
Agent Licensed in UT
No, it is not a common problem. The best way to locate a dentist is to search for one on the companies website where you have your Medicare Advantage plan.
Yes. Your Medicre Advantage plan is an HMO, so you have to go to a dentist who’s in your plan’s network.
Answered by Charles Borg on April 9, 2025
Agent Licensed in FL & NY
I wouldn't say it is a common problem but it does happen. It is very important to check all of your Doctors, Dentist, etc before choosing a Medicare Advantage Plan. Most Advantage plans give a set dollar amount per year to use for dental services. In my area, many (not all) of those plans will pay the same on dental services regardless if the dentist is in or out of network. I would recommend checking your plan's Summary of Benefits to see how your plan's dental benefits work out of network. You can request a book or go to your plan's website to find that info.
Yes it is, however some PPO plans provide dental coverage both in and out of network with the same costs associated with the service.
Tags:
Coverage
Medicare Advantage
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