My Medicare Advantage plan advertised dental coverage, but it barely covers anything. Is this normal?
Answered by 11 licensed agents
While many Advantage plans vary between networks and carriers, it's important to note that some can offer substantial coverage, and I’ve seen some reaching up to $1,700 per year for dental services. The type of coverage depends on whether it’s root canals or plain fillings, and that needs to be considered. However, it's essential to recognize that these plans may not be as comprehensive as standalone dental plans. Verify that your dental clinic is within the plan’s PPO or HMO network to maximize your benefits. This ensures you receive maximum benefits.
Dental coverage like most coverages vary from company to company and plan to plan. When sitting down with your Medicare or Health Insurance Broker, be sure to mention any services you hope to have done or coverages you’d like to make sure you have. This way, your Broker can find a plan that is tailored for your needs and expectations.
No that is not normal. You must have just picked a plan with lower coverage. There are many plans that will Cover up to 2000 in dental and you can pick any dentist.
When open enrollment occurs I would change plans that have all your doctors, drugs and better dental coverage.
Dental Plans outside of Medicare Advantage often offer "discount" plans that still have clients paying for major dental work, so Medicare Advantage Plans often mirror those...some Plans offer higher amounts of coverage which you should review with your Broker.
This is a common occurrence. While your plan may include dental coverage it’s also important to check to see which procedures are covered under that benefit. Medicare Advantage plans change benefits every year. Along with the annual coverage limit there will also be a list of procedures that are covered and not all procedures may be covered 100% Its important to know what percentage of those procedures are covered. The coverage info will be summarized in your summary of benefits and expanded coverage info will be available on your Evidence of Coverage document. If you’re working with an agent or broker, they should be able to explain the benefits in great detail. I hope this information helps.
Most Medicare Advantage plans offer basic dental coverage. In most cases, it is not to be considered comprehensive in nature. However, some Advantage plans offer additional supplemental coverage for an additional premium. Many people also elect "stand alone" policies outside their Advantage plans.
Unfortunately, it is normal, they are discount plans. They do sell upgrade HMO plans, or you can always purchase PPO plans outside your Medicare Advantage plan.
Most, if not all, advantage plans come with some dental coverage. It ranges from $1000-$5000 in maximum annual benefits. Every plan has a Summary of Benefits and the more detailed Evidence of Coverage document which clearly state what the plan does and does not cover. Prior to any dental procedure we advise that you check with your dentist's office to see what would be covered prior to your appointment.
Unfortunately that is common and normal with some Medicare advantage plans. In order to get additional dental coverage you could purchase a separate supplemental dental plan. Most supplemental plans are fairly inexpensive and could provide the extra benefits you're seeking. Talk to a insurance broker, like me, to help you find the best coverage for the best price.
