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Best Medicare Advantage Dental Plans – Vested Daily

Best Medicare Advantage Dental Plans

The best Medicare dental plans will depend on your needs. Original Medicare doesn’t cover routine dental services, such as cleanings, fillings and extractions. For dental coverage, Medicare-eligible people can buy a separate policy or turn to Medicare Advantage plans, most of which offer some form of cost help for dental care.

Medicare Advantage plans are a bundled alternative to Original Medicare, sold by private insurers. They include Medicare Part A (hospital coverage) and Part B (medical insurance) and usually Part D (prescription drug benefits). These plans charge a monthly premium or (frequently) no premium, and they often include extra benefits such as some coverage for hearing and vision care.

Each plan also gets a star rating from the Centers for Medicare & Medicaid Services, or CMS, on a scale of 1 star (worst) to 5 stars (best) based on the quality of care and customer satisfaction.

The vast majority (94%) of people enrolled in Medicare Advantage plans have access to dental care, although the type of coverage and limits on cost sharing vary. (A plan might cover twice-a-year cleanings, for instance, but no fillings or other dental work.)

In 2021, 42% of Medicare beneficiaries were enrolled in a Medicare Advantage plan, accounting for more than 26 million people. If you’re looking for the best dental insurance for people on Medicare Advantage, here are our top picks for 2022.

Best for size of dental network: UnitedHealthcare

Average Medicare star rating: 4.2 out of 5.

Service area: Available in 50 states and Washington, D.C.

Standout feature: UnitedHealthcare has the largest network of dental providers of all Medicare Advantage companies, with approximately 100,000 providers.

UnitedHealthcare is the biggest provider of Medicare Advantage plans in the U.S., with a presence in all 50 states and plans available in almost three-quarters of U.S. counties. UnitedHealthcare also partners with AARP and insures Medicare products with the AARP name. Many of UHC’s members are in plans with high star ratings.

Pros:

  • UHC offers the largest Medicare dental network, with approximately 100,000 providers.

  • UHC plans with comprehensive dental coverage include an average of six services per plan.

  • Three-quarters of UHC Medicare Advantage members are in highly rated plans.

Cons:

  • Only 75% of UHC plans offer comprehensive dental coverage, one of the lowest among the major Medicare Advantage providers.

  • UHC tied for sixth out of nine providers on J.D. Power’s latest Medicare Advantage study, which measured member satisfaction.

Best for comprehensive coverage: Cigna and Aetna (tie)

Cigna

Average Medicare star rating: 4.2 out of 5.

Service area: Available in 26 states and Washington, D.C.

Standout feature: Nearly every Cigna Medicare Advantage plan comes with both preventive and comprehensive dental coverage, including coverage for endodontics, extractions and restorative services.

Nerdy tip: Preventive dental coverage may include cleanings, fluoride treatment, X-rays and exams. Comprehensive dental coverage may include diagnostic services, periodontics (gums), extractions, restorative services (fillings, bridges), endodontics (root canals) and prosthodontics (artificial teeth).

Cigna isn’t the largest Medicare Advantage provider, but the company’s plans come packed with benefits, which may include preventive and comprehensive dental, 24/7 telehealth and meal delivery. More than three-quarters of Cigna’s Medicare Advantage plans have a $0 premium, and Cigna’s comprehensive dental coverage includes an average of nearly seven covered services.

Pros:

  • Nearly all Cigna Medicare Advantage members will get both preventive and comprehensive dental coverage.

  • The average Cigna dental plan with comprehensive coverage includes almost seven covered services.

  • Cigna Healthspring, a Cigna subsidiary, landed a third-place ranking in J.D. Power’s latest Medicare Advantage study based on member satisfaction.

Cons:

  • Cigna plans are only available in 26 states and Washington, D.C.

  • The majority of Cigna’s Medicare Advantage plans are HMOs, which require members to get most of their care from in-network providers.

  • Cigna’s plans don’t get the highest marks from the National Committee for Quality Assurance, scoring only 2.5 to 3.5 out of 5 for all plans.

Aetna

Average Medicare star rating: 3.8 out of 5.

Service area: Available in 46 states and Washington, D.C.

Standout feature: About nine out of 10 Aetna Medicare Advantage plans provide comprehensive dental coverage and average nearly seven included services per plan, from periodontics to extractions to restorative services. (Ninety-seven percent of Aetna plans offer preventive dental care, which includes cleanings and X-rays.)

Aetna, a CVS Health company, is the fourth-biggest provider of Medicare Advantage plans, and 84% of Medicare beneficiaries have the option of a $0-premium Aetna plan. Aetna also offers stand-alone prescription drug plans in all 50 states and Washington, D.C., including one of the lowest-premium plans nationwide.

Pros:

  • Aetna is available in most states and Washington, D.C.

  • Preventive dental services (cleaning, X-rays and exams) are covered at 100% on most plans.

  • Some Aetna Medicare Advantage plans offer a variety of other perks, such as an over-the-counter allowance and meal delivery services.

Cons:

  • The Centers for Medicare & Medicaid Services, or CMS, gives Aetna’s 2022 Medicare Advantage plans an average star rating of 3.8 out of 5 stars, which is below the national average of 4.37.

  • Aetna placed sixth out of nine Medicare Advantage providers on J.D. Power’s latest Medicare Advantage study, which was based on member satisfaction.

Honorable mention: Wellcare

Nearly all of Wellcare’s Medicare Advantage plans offer comprehensive dental care, with 96% of plans offering both preventive and comprehensive dental coverage, averaging just over six covered comprehensive services per plan. Wellcare is available in 36 states.

Best for member satisfaction: Kaiser Permanente

Average Medicare star rating: 5 out of 5.

Service area: Available in eight states and Washington, D.C.

Standout feature: Kaiser Permanente netted the top spot out of nine providers on J.D. Power’s most recent U.S. Medicare Advantage study, which is based on customer satisfaction.

Kaiser Permanente is the fifth-largest provider of Medicare Advantage plans, and the company gets high ratings from the CMS as well as outside ratings agencies. Most of Kaiser’s Medicare Advantage plans come with dental coverage.

Pros:

  • About nine out of 10 Kaiser Permanente Medicare Advantage plans offer preventive dental coverage, and 84% also offer comprehensive dental coverage.

  • Most of Kaiser’s plans offer access to supplemental dental coverage if you need it, for as little as $9 per month.

  • Of the seven Medicare health plans that got a 5 out of 5 rating from the National Committee for Quality Assurance in 2021, four of them are Kaiser plans.

Cons:

  • Kaiser’s comprehensive dental coverage includes an average of only four covered services per plan. (Most common: diagnostic services, periodontics and extractions.)

  • Kaiser Permanente plans are available in only eight states and Washington, D.C. (Those states are California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia and Washington state.)

  • Kaiser offers only HMO plans, so members must use Kaiser’s network of providers.

Best for low-cost plans: Humana

Average Medicare star rating: 4.1 out of 5.

Service area: Available in 47 states and Puerto Rico.

Standout feature: Humana offers $0-premium Medicare Advantage plans in 47 states and Puerto Rico, and about half of Humana members are in a $0-premium plan.

Humana is the second-biggest provider of Medicare Advantage plans and is available in more U.S. counties than any provider. Humana plans enjoy good Medicare star ratings, and nearly all of Humana’s members are in highly rated plans.

Pros:

  • Eighty-nine percent of Humana Medicare Advantage plans offer preventive dental coverage, and 83% offer comprehensive dental coverage.

  • Humana offers plans in 85% of U.S. counties, making it an option for more people than any other Medicare Advantage provider.

  • Nearly all Humana Medicare Advantage members (97%) are in a plan rated 4 stars or higher (out of 5) by the CMS.

Cons:

  • Humana’s comprehensive dental coverage includes only about three services, on average. (Most common: restorative services, extractions and periodontics.)

  • Humana came in only slightly above industry average, ranking fourth out of nine providers in J.D. Power’s most recent Medicare Advantage study, which measured member satisfaction.

What dental care does Medicare Advantage cover?

Medicare Advantage dental coverage may be as basic as annual cleanings and X-rays, or a plan may cover more comprehensive services like extractions and dentures. Many plans have an annual dollar limit on coverage, so although a plan may cover comprehensive services, if you need significant work done in one year, you may still spend a good amount out of pocket.

A plan may also require prior authorization for more expensive services. (About 82% of people enrolled in Medicare Advantage will need prior authorization for comprehensive dental services.)

How much does dental care cost with Medicare Advantage?

Dental costs on a Medicare Advantage plan will vary by plan and by service. Some plans require a copay or coinsurance for every service. For instance, if there’s 50% coinsurance (the most common setup) required for a filling, you would pay 50% of the cost. Some services have a $0 copay if you use an in-network provider but require coinsurance or aren’t covered if you go out of network.

It’s worth noting that services may often be covered at a $0 copay, but with a dollar limit to what the plan will cover. For instance, there may be a $1,000 annual maximum benefit for preventive or comprehensive services (or both). For people enrolled in plans with more comprehensive dental benefits, the average annual dollar limit on coverage is $1,300, according to the Kaiser Family Foundation. It’s important to read a plan’s Evidence of Coverage to understand the limits on any dental coverage being offered.

What if you have Original Medicare?

If you have Original Medicare, you’ll need to buy a separate dental insurance policy to cover your dental needs or pay out of pocket for dental care. Many of the Medicare Advantage providers also sell separate dental policies, or you can look for policies with companies like Delta Dental, Liberty, Spirit Dental or Guardian.

How to shop for Medicare Advantage plans

Medicare Advantage plans aren’t just about dental coverage — you’ve got to get the right coverage for all of your health care. Here are some strategies for finding the best plan for you:

  • Check star ratings. The CMS collects data on Medicare Advantage plans from member surveys, the plans themselves and medical providers, and then assigns a star rating based on the results. The star rating is on a scale of 1 to 5, with 5 being the best.

  • Compare out-of-pocket costs. Each plan will have a monthly premium (many Medicare Advantage plans have no premium) and a maximum out-of-pocket cost, which is the most you’ll pay in a year for covered health care.

  • Keep your meds in mind. Your medications may seem like an afterthought, but make sure you investigate how each plan will cover your medications — or whether they’re covered at all.

  • Look for your doctors. If you’ve got a list of caregivers and medical facilities you use and prefer, look for plans that include them.

  • Consider the plan type. If you see specialists frequently and you don’t want to seek a referral for every office visit, a PPO plan is probably the better fit. If you’re a light health care user and see mostly your primary care physician, an HMO might be more affordable.

  • Drill down on dental. If a plan notes that it offers dental, keep clicking until you get all the details in a plan’s Evidence of Coverage. Make sure you understand what services are included, what kind of copays and coinsurance you may have to pay, and whether there’s an annual limit on what the plan will spend.

You can sign up for a Medicare Advantage plan when you first become eligible for Medicare (your initial enrollment period) or during designated annual Medicare enrollment periods, such as fall open enrollment.

This post was originally published on Nerd Wallet

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