Center for a Secure Retirement
What You Need to Know About Medicare Advantage Dental Insurance

What You Need to Know About Medicare Advantage Dental Insurance

Receiving health coverage through Medicare requires you to make choices that may be new to you. If you previously used health insurance from an employer, new rules and terminology can take some getting used to, and dental coverage is something that catches many retirees by surprise. Fortunately, you have several options available, including Medicare Advantage dental insurance.

Dental health is essential throughout life, and that's especially true as your body ages during retirement. You'll want to stay on top of routine exams and cleaning, and you may experience more serious issues occasionally.

Traditional Medicare does not cover most dental care. As a result, you need to make arrangements for everything from routine visits to comprehensive treatments and hardware.

Medicare Advantage Dental Insurance

Medicare Advantage, also known as Medicare Part C, is a popular way to receive dental coverage in retirement. These optional plans can help pay for everything from cleanings and X-rays to more advanced care like root canals. Different insurers offer different levels of coverage, so you can often find a plan that fits your budget and your needs.

A Medicare Advantage plan is an alternative to traditional Medicare. You have "all in one" coverage, which goes beyond Medicare's traditional Part A and Part B coverage. For example, you might get dental care, vision benefits and prescription drug coverage, among other things.

Some Medicare Advantage plans may require you to pay a premium while others have no premium, and you typically need to pay a portion of the costs for medical care. To get dental coverage with a Medicare Advantage plan, shop among Medicare-approved insurance companies. As you compare offers, evaluate the following features.

Services Available

Research what type of care is available. Some plans only cover preventative services like cleanings and X-rays. What's more, those services may be limited. For example, you might only be able to receive two cleanings per year. Other plans pay for more extensive dental work, and those may be appropriate if you regularly need fillings, dentures and other services.

Co-pays and Coinsurance

Find out how much you pay and whether you pay a flat fee or a percentage of costs. A co-pay is a flat dollar amount for services, while coinsurance might require you to pay 50%, or some other amount, of every bill.

Provider Availability

Ask your dentist which plans work best and which networks the dental office participates in. Some plans might not work with your current dentist, requiring you to search for a new provider.

Annual Limits

Plans often have maximum limits on how much they pay out each year. For example, if your plan's limit is $1,000 and you need a substantial amount of dental work, you may have to pay out of pocket after you reach the maximum.

Health Insurance

Keep the big picture in mind. While dental coverage is crucial, other forms of health care might be more important. Choose a plan with your essential needs in mind (including any prescriptions you take), and then look at dental coverage.

How Much Do You Pay?

Again, many Medicare Advantage plans don't require you to pay a premium. But you can usually expect more comprehensive coverage with plans that do have premiums.

You may also face co-pays or coinsurance charges. When your plan uses coinsurance, it's smart to ask how much a procedure will cost and compare pricing with other dentists. After you reach the plan's coverage limit, you may be responsible for all costs.

Key Takeaways

You may be accustomed to having dental insurance provided by an employer, but that benefit isn't available in traditional Medicare. Still, there are several ways to get insurance for dental work when you're retired. Medicare Advantage dental insurance helps with dental care as well as other services, and in some cases, you pay no premiums. Research offerings with the big picture in mind — including services beyond dental care — and you're likely to find a solution that meets your needs.

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