Dental Benefits |

Dental Benefits

Dental care is an important part of taking care of your overall health.

Many of our Medicare Advantage plans include dental benefits, and we know that you may have questions about your dental coverage. We're here to answer your questions and break it down for you. 

Our plan covers the following dental services:

  • Examinations and evaluations are covered once every six months
  • Cleaning is a covered benefit once every six months
  • Silver diamine fluoride treatment is covered with a maximum of six applications per lifetime
  • X-rays
  • Bitewing x-rays are a covered benefit only once in a 12-month period
  • A panoramic x-ray is a covered benefit once every five years
  • A full mouth or complete series of x-rays is a covered benefit once every five years
  • Fillings
  • Tooth extractions
  • Complete or partial dentures are covered once every five years
  • Sealants are covered once every three years, if criteria are met
  • Indirect restorations (crowns) are covered once every 5 years per tooth, if criteria are met
  • Root canal therapy/re-treatment of previous root canal
  • Comprehensive periodontal evaluation
  • Scaling in presence of inflammation
  • Periodontal scaling and root planing
  • Other periodontal maintenance

Additional services are available, see the Member Handbook for more details.

You can find more information about your benefits, including what exact services are covered by your plan, by checking your Member Handbook.

It's important to make sure your dentist is in-network. If you see a dentist that's not in your plan's network, your exam and other services may not be covered by your plan, which means you may have to pay more out-of-pocket. To find an in-network dentist, use the Find a Provider tool.

You should see your dentist for an oral exam and cleaning twice a year. You should also schedule an appointment with your dentist whenever you have problems with your teeth, jaw or gums.

Your dentist may refer you to a specialist, like an oral surgeon, an endodontist or a periodontist if you need a special procedure like a root canal or tooth extraction.

A dental exam helps your dentist assess the overall health of your mouth, teeth and jaw. Every dental exam may be slightly different based on the situation. However, most dental exams include dental X-rays, an oral exam, a check for signs of oral cancer and a teeth cleaning.

Your member ID card is the key to receiving the care you need. You will need to bring your Member ID card with you to all your appointments.  

If you can't find your Member ID card, you can log into your member portal and print a copy or log in on your cell phone to view your digital ID card. 

When you go to pay, make sure to mention the name of your dental vendor, which is listed on the back of your Member ID Card.

Additional Questions? Contact Us

Thank you for trusting us with your healthcare needs. We appreciate you being a member, and hope this information helps you better understand your dental benefits.

If you have questions, please contact Member Services.