There are some Medicare Advantage plans that come with options that cover basic and major dental services, such as dental implants. Some of these providers have different ways that they go about providing dental coverage, so that it’s not just a flat fee. This article can help break down some of the common occurrences that you may see if you do have to deal with dental implants and coverage. Not all situations are the same and you may see that your situation differs slightly or entirely from what’s provided below. Be sure to speak with a Robert J Stillwell representative so that they can lay out, in more detail, what you may expect and can answer any questions specific to you and your coverage.
Limiting the Cap and Services
You may find that some providers have a limit on what they will cover or how much they are willing to pay in coverage. You’ll usually see limits come in around $1,000- $3.000, as well as a limit on some of the services that they will cover. For that reason, it’s essential to speak with your Medicare Advantage provider to see if dental implants are covered.
Premium Add-On
Some Medicare Advantage providers can offer multiple options for benefits that go beyond the minimum requirements. These will most likely come with additional premiums, so be sure to chat with a representative about what you may be looking at.
Cost-Sharing
Another way that you may see this covered is with cost-sharing. Some providers may cover a percentage of the total costs or simply a flat fee, similar to the cap limit. You may typically see coinsurance rates varying from 20% – 70% of what the provider will cover for extensive dental surgery. The rest of the money that is needed toward the implants would come out of pocket or from another source.
Medicare Advantage plans can vastly differ in terms of their coverage so it’s important to speak with your provider and understand what coverage you have. You should be given an Evidence of Coverage notice, that should specify whether or not your coverage will take care of dental implants. This notice will also go into detail about how much you may need to come out of pocket with. There are options to obtain additional coverage for dental implants, which a representative would be more than happy to walk you through. There are so many moving parts to this and what will and will not be covered at different stages of this procedure. That’s why it’s imperative to have a company that you can go to with questions like this and that can put your mind at ease. Going through this surgery is stressful enough, you don’t want to add more stress to it by trying to figure out what is and isn’t covered all on your own.