Understanding Medicare Advantage dental coverage and benefits

Dental care is a vital part of maintaining your health and well-being, especially as you age. And one of the main perks of joining a Medicare Advantage (MA) plan is that many plans offer dental coverage to help you keep up with your oral health.

Original Medicare (Medicare Parts A and B), on the other hand, does not cover routine dental care, such as oral exams, cleanings and X-rays. Due to the relatively high out-of-pocket costs for these procedures, some older adults end up forgoing necessary dental care. Aetna® offers Medicare Advantage PPO plans that cover preventive dental care, including cleanings and oral exams. We also have plans that cover even more dental services, like fillings and extractions. For some Aetna® MA plans that don’t include comprehensive dental coverage, you may have the choice of paying extra each month for dental benefits. This is done through an optional supplemental benefit.

Aetna MA plans offer network dental benefits

For PPO plans, you have the option to go to any licensed provider but could save money by using a provider in network.

Network dental benefits with Medicare Advantage

With Medicare Advantage (Medicare Part C) plans that include a network dental benefit, you’re covered up front for specified dental services but may be required to see a dentist within your network of providers. Some preferred provider organization (PPO) and health maintenance organization point-of-service (HMO-POS) plans, however, do allow you to see any licensed dental provider, but you may save money by seeing a provider in our network. You can find a network provider by searching our provider directory.

Preventive dental services such as cleanings, oral exams and X-rays are covered at 100 percent on most plans. This means you pay nothing out of pocket if you stay in network. For comprehensive services, such as fillings, extractions and crowns, the coverage varies according to plan, and you may have to pay a portion of the cost of services. Check with your dental plan for more details.

As you plan for your dental care, keep in mind that you may have limits on the number of preventive care visits you can make each year, as well as caps on coverage for comprehensive services. And remember that not all plans offer comprehensive dental coverage. You can find specific benefit details in your plan’s Evidence of Coverage.

Optional supplemental dental benefits

While most MA Medicare Advantage plans include preventive dental services, you may have the option to purchase even more dental benefits for an additional monthly premium. Aetna members must enroll in this option when they enroll in their plan, or within 30 days of their plan’s start date.

As you age, maintaining your oral health is an important part of your whole-body wellness. And with Aetna MA plans, you have a variety of options to make it more affordable and easier to keep up with your dental care.

About the author

Sachi Fujimori is a writer and editor based in Brooklyn who focuses on writing about science and health.  A good day is one where she eats her vegetables and remembers to live in the moment with her baby girl.