How It Works
Most dental plans for Medicare beneficiaries work on a tiered structure. Preventive care like cleanings, exams, and X-rays is usually covered at or near 100%. Basic work like fillings and simple extractions is covered at a percentage, often 70 to 80%. Major work, including crowns, bridges, dentures, root canals, and implants, is covered at a lower percentage, typically 50%.
Each plan has an annual maximum, the most it will pay in a year, and many have a waiting period before major services kick in. The right plan depends on what you actually need. Someone who just wants cleanings covered shouldn't pay for a plan built around implants, and someone who knows they have major work coming needs a plan without a long waiting period.
Some plans also bundle vision and hearing benefits, which can be a good value if you use them and a waste if you don't. I'll walk you through what's included so you're not paying for extras.
Who It's For
If you're on Original Medicare with a Medigap supplement, you have no dental coverage at all, so a standalone dental plan is usually the only way to get it.
If you're on a Medicare Advantage plan, you may already have some dental built in. Those benefits are often limited, though, with low annual caps or narrow networks, and a standalone plan can fill the gaps or give you access to your own dentist.
Dental plans are available year-round, not just during Medicare enrollment periods, and most have no health questions. If you're already paying out of pocket for two cleanings a year, a plan often costs about the same and covers a lot more.
Adding It to Your Coverage
A dental plan is a standalone policy, so it sits alongside your Medicare Advantage or Medigap plan without changing it. Coverage usually starts the first of the following month. I'll check whether your current dentist is in network before we pick a plan, and if you're already a client, this is an easy add at your annual review.
Add Dental Coverage with
Holowchuk Health Advisors
Let's find a dental plan that fits your needs and your dentist. Call (732) 554-3021 or book a free consultation below.