My Medicare Advantage plan covers dental, but I can't find a dentist who accepts it. Is this a common problem?
Answered by 13 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.
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.
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.
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
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.
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!
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.
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.
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.
