My Medicare Advantage plan covers dental, but I can't find a dentist who accepts it. Is this a common problem?

Question

Valentina Gatewood · Accepted Answer

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.

Charise Karjala · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/medicare-advantage-dental-coverage-finding-providers#charise-karjala

Misty Bolt · Answer

No what city and state are you in? I can look for one that  have dentist in the network. Also depends on MA plan.

David Bell · Answer

Not generally. That is something to research before you sign up. Same with doctors and’s vision. If you dentist doesn’t take the plan, it never hurts to ask if they would consider it. The companies are usually looking for more providers.

Answered by David Bell on May 26, 2025

Agent Licensed in ID, AZ, CA & 8 other states

Answered by David Bell Medicare Insurance Agent

Yasmine Lopez · Answer

It’s not something I see often, but it can happen — especially in certain areas where fewer dentists accept insurance or where the dental network tied to the plan is limited.

If you're having trouble finding an in-network dentist, here are a few options I typically recommend:

Let’s check other Medicare Advantage plans in your area. Some plans have much broader dental networks than others — and we may find one that includes your preferred providers.

Consider a stand-alone dental insurance plan. If dental care is a priority and your Medicare plan’s network isn’t meeting your needs, we can look into stand-alone dental coverage that offers more flexibility.

Ask your current dentist about a cash-pay discount plan. Many dental offices offer membership or savings programs for patients without traditional insurance — and these can sometimes be more cost-effective than using insurance at all.

The bottom line: you have options, and I’m here to help you find the one.

Carolee Turner · Answer

Not necessarily, depending on the Insurance company utiliized and the member portal if the member understands how it works. Many new and old members of United Healthcare have been educated on how to search the directory on their member portal by their local agents outreach and the education during the enrollment process. We also hold member appreciation meetings bi-annually to continue with the latest news and updates for our members. If a member already has a dentist they prefer to deal with, and the dentist is not in the network, the dentist can charge 15 percent higher than the negotiated rate of the insurance company. However, if the member files a claim through their member portal, they will be reimbursed for the rate the insurance company will pay for certain procedures. This varies upon each insurance company and their limitations & exclusions of course.

Answered by Carolee Turner on May 13, 2025

Agent Licensed in FL, IL, MI, OH, SC & TN

Answered by Carolee Turner Medicare Insurance Agent

Steven Bleicher · Answer

This problem should not have arisen! I say that since an agent is personally responsible for the acquisition of an Advantage plan. She/he should have checked all of your doctors, specialists, Rx's, labs, as well as a dentist who is a part of your plan's network. If that was not done, then the only choice you'll have is to pick a dentist in the plan, until next year when you can make a change. Please understand that in the area of Dental, your Advantage plan will only cover the routine treatments like x-rays, fluoride treatment, cleanings, etc. and NOT the more expensive root canals, crowns, bridges, caps, etc. Those types of procedures are only covered by a private, individual "DVH"(Dental, Vision & Hearing plan) which contains a monthly premium.

So, during the upcoming fall Annual Open Enrollment period from 10/15 thru 12/7/25, your agent must review those important doctors for you. Be advised however, that sometimes when I have been given for example, 5 doctors whom my client deems are essential to be retained, three of those doctors are in one network and the remaining two doctors are a part of a different network. NOW, you have to make a choice as to which of those 2 groups are your better choice. That naturally means that with the "unchosen group", specifically those doctors will need to be replaced with network doctors in their areas of specialty.

Michael Pyers · Answer

They usually have limited networks. However, some are PPO and you can see any Dentist and pay a little more.

Bruce Kern · Answer

Your agent should have checked to see that you plan covered your doctors and dentist before you sign up for that plan

Ami Fouts · Answer

It depends on what plan you have. You should call your broker and have them do the research for you. That’s what us brokers are here for.

Rosalind Ryan · Answer

Yes, finding a dentist who accepts your specific Medicare Advantage plan, especially if it includes dental coverage, can be challenging. While many Medicare Advantage plans include dental coverage, a large number of dentists may not actively participate in these networks for a variety of reasons.   

To find a dentist under your Medicare Advantage plan, start by checking your plan’s provider directory for in-network options—don’t rely solely on online searches, as they may be outdated. If you’re having trouble, contact your plan directly for help locating a participating dentist and understanding your coverage. Some plans offer limited out-of-network benefits, so review any cost-sharing details before proceeding. If no in-network dentists are available, explore alternatives like dental discount plans, separate private dental insurance, low-cost clinics, or Medicaid (if eligible). Your insurance company may also offer assistance in finding a provider or exploring other options.

William Pierce · Answer

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

Answered by William Pierce Medicare Insurance Agent

Fred Manas · Answer

Yes, finding a dentist who accepts your Medicare Advantage dental plan can be a common challenge. Many private dentists don't accept Medicare plans due to low reimbursement rates and other factors. Medicare Advantage plans often offer limited dental coverage, which may not be sufficient for dentists to accept. 
Here's a more detailed explanation:
Low Reimbursement Rates:
Dentists may refuse to accept Medicare Advantage plans because the reimbursement rates are low, potentially making it difficult to cover their costs. 
Limited Coverage:
Medicare Advantage plans may only cover a limited range of dental services or have high copays, making them less attractive to dentists who prefer to work with patients who can cover the full cost of their services. 
Administrative Burden:
Dealing with Medicare's administrative procedures can be complex and time-consuming for dentists, which may lead them to prefer patients who have easier-to-manage insurance plans. 
Patient Expectations:
Some patients may have unrealistic expectations about dental coverage under Medicare, which can lead to dissatisfaction and difficulty managing patient relations. 
What to do if you're having trouble finding a dentist:
Review your plan's "Evidence of Coverage":
.
This document outlines the specific benefits and limitations of your plan, including information on dental coverage. 
Contact your plan's customer service: They can provide you with a list of in-network dentists and help you understand your coverage. Use your plan's online directory: Many plans have online tools that allow you to search for in-network dentists based on your location and specific needs. 
Consider "out-of-network" benefits: Some plans may offer limited out-of-network coverage, but it's likely to come with higher cost-sharing. 
Be patient and persistent:. Finding a dentist who accepts your plan may require some effort, but it's worth it to ensure you're able to access the dental care you need. 
Explore other options.

Steve Brauer · Answer

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

Answered by Steve Brauer Medicare Insurance Agent

Mike Henry · Answer

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

Answered by Mike Henry Medicare Insurance Agent

Suzanne Lamperti · Answer

That's why I Don promise Advantage plans. It's better to get a separate dental plan, stand alone prescription plan,  and Origional Medicare.

Linda Davies · Answer

To find a dentist who accepts your Medicare plan, start by checking your plan's website for a provider directory. You can also use online tools like Zocdoc, Aetna's provider search, or Humana's dentist finder, specifying your plan and location. If you have a Medicare Advantage plan, check if it includes dental coverage and use their specific provider search tool. 

Here's a more detailed breakdown:

1. Check your plan's website:
Many insurance companies, like Aetna, Humana, and Wellcare, have online tools to search for dentists in their network. You'll typically need to enter your plan type, ZIP code, and network name (found on your insurance card). 

2. Use online directories:
Websites like Zocdoc allow you to search for dentists by location and filter by those who accept Medicare. 

3. Verify coverage with your plan:
Even if a dentist is listed as a network provider, it's a good idea to confirm with your plan directly that they accept your specific plan and what the coverage details are. 

4. Consider Medicare Advantage plans:
If you have a Medicare Advantage plan, it might include dental coverage, and you can find participating dentists through your plan's provider directory. 

5. Consult the official Medicare website:
The official Medicare website provides general information about dental coverage and can guide you to resources for finding providers. 

6. Consider Community Health Centers:
These centers often offer dental services on a sliding scale for those with limited incomes. 

7. Contact your State Health Insurance Assistance Program (SHIP):
SHIPs can provide free and unbiased counseling about Medicare benefits and help you find dentists who accept Medicare.

Deborah Webster · Answer

No, you should be able to access the dentist who are participating by calling member services or go on your member website to look up the dentist who are participating with your Medicare advantage carrier.

Answered by Deborah Webster on May 5, 2025

Broker Licensed in Ia & SC

Answered by Deborah Webster Medicare Insurance Agent

Jerry Cohen · Answer

Situations difer depending on the type of provider being searched. The best thing to do is call the Customer Service area at the company you are covered by and explain that you cannot find a dentist anywhere near your home and let them look into the situation. Often times the company has names of providers that for whatever reason are not listed on the web portal covered people have access to.

Answered by Jerry Cohen on May 13, 2025

Broker Licensed in NY

Answered by Jerry Cohen Medicare Insurance Agent

Larry Pereiro · Answer

Yes it is, however some PPO plans provide dental coverage both in and out of network with the same costs associated with the service.

Charles Borg · Answer

Yes. Your Medicre Advantage plan is an HMO, so you have to go to a dentist who’s in your plan’s network.

Ross Landon · Answer

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

Answered by Ross Landon Medicare Insurance Agent

Kris Neupauer · Answer

It’s frustrating, but you’re not alone—lots of people have this same issue. It just means you might have to do a little extra searching to find a dentist who accepts your plan. That's where I will come in. I will either have a list of dentist in your area that work with an Advantage plan if you choose one or, I will do the work for you IF you chose an Advantage plan.

Answered by Kris Neupauer on May 1, 2025

Broker Licensed in MN, ND, SD & WI

Answered by Kris Neupauer Medicare Insurance Agent

Michael Turkaly · Answer

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.

Christopher Stewart · Answer

A lot of MA plans cover dental, to an extent. However, Medicare does not reimburse the plans for this benefit so the carrier comes out of pocket, often times leading to smaller/limited networks. So, in short, the answer is yes more often than not.

Answered by Christopher Stewart on May 29, 2025

Broker Licensed in FL, AL, AZ, CO & KS

Answered by Christopher Stewart Medicare Insurance Agent

Jessica Breland · Answer

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.

Answered by Jessica Breland on April 14, 2025

Broker Licensed in LA

Answered by Jessica Breland Medicare Insurance Agent

Shannon Brenneke · Answer

Many dentists do not contract directly with insurance companies, however, if your plan is a PPO plan, you should still be able to utilize those dentists. Be sure to ask your dentist if they will still file the claim for you, even if they are not in the network, so you can utilize the plan benefits.

Answered by Shannon Brenneke on May 19, 2025

Agent Licensed in MO

Answered by Shannon Brenneke Medicare Insurance Agent

Joseph Smith · Answer

Yes! This is a common problem. Most plans provide a list of dentists that accept your plan. You can obtain the list by contacting your plan.

Brittany Garrison · Answer

You're 1000% NOT the only person frustrated by this. A lot of Dentists sometimes work on a separate network all together from the one your PCP may use. So here's what I'd suggest, call the number on the back of your card for Member Services and ask for the dental network name. You can search the carriers website for in-network dentists near where you live. Lastly, if you feel like that network is just too limited, consider this to be something to review during AEP and/or consider adding on a stand alone dental policy! Hope this helps.

Answered by Brittany Garrison on June 3, 2025

Broker Licensed in GA, AL, AR & 20 other states

Answered by Brittany Garrison Medicare Insurance Agent

My Medicare Advantage plan covers dental, but I can't find a dentist who accepts it. Is this a common problem?

Agents: Share Your Expertise

Seniors: Ask a Question of Your Own

Related Questions

Agent Locator

Medicare Agents Hub
A non-government resource website

My Medicare Advantage plan covers dental, but I can't find a dentist who accepts it. Is this a common problem?

Agents: Share Your Expertise

Seniors: Ask a Question of Your Own

Related Questions

Agent Locator

Medicare Agents HubA non-government resource website

Medicare Agents Hub
A non-government resource website