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Medicare Dental Plans

Dental Insurance for Seniors in Chicago, IL

In general, the dental benefits found in Original Medicare Parts A and B are not true “dental insurance” Medicare does not cover routine, preventive or comprehensive dental insurance coverage. Most Medicare Supplements or Medigap plans don’t cover dental insurance benefits, either. Original Medicare (Parts A and B) usually only covers dental work deemed medically necessary, which limits its application for most needs. Medicare Advantage plans typically offer more extensive dental benefits; however, enrollees often must pay coinsurance for most services and may face annual dollar limits on coverage.

Let’s dive into how dental insurance works with Medicare insurance planning.

Medicare Dental Insurance Plans

There are many dental insurance options out there for seniors in Illinois, but you’ve got to know where to look and what to look for. You don’t want to buy a plan that doesn’t meet your individual needs, or simply provide discounts. Discount dental plans are just that – discount plans. They’re not “real” insurance.

Plus, there are a lot of off-brand companies out there selling dental insurance that may or may not be great options for you. That’s where Chicagoland Medicare comes in to help you find the best dental insurance plans in Chicago, IL!

Medicare Dental Insurance – Two Options

While Original Medicare doesn’t provide much in the way of dental coverage, there are two ways to go about getting dental insurance when you’re on Medicare. Dental coverage isn't included with Original Medicare (Parts A and B). However, certain Medicare Advantage plans may provide dental benefits depending on their plan; their scope varies, and high cost-sharing out of your own pocket may apply. These private plans combine Parts A and B together and may include extra benefits like vision or hearing care coverage at significantly reduced monthly premiums than traditional Medicare Part B premiums.

There are also opportunities for people on Medicare to buy stand-alone, or independent dental insurance policies. The two options are:

1. Buy a Medicare Advantage plan with dental benefits embedded within the plan.

2. Buy a stand-alone, independent dental insurance policy.

Read on to learn more.

Make an appointment at Chicagoland Medicare to explore both options whenever you’re ready!

Medicare Advantage Dental Plans

The first option for getting dental insurance is to buy a Medicare Advantage plan with dental insurance embedded within the benefits of the plan.

In 2023, over half of Medicare Advantage plans that offered comprehensive dental benefits had an annual maximum benefit limit for these services; however, Medicare Advantage insurance companies are increasingly adding or increasing dental benefits into their Medicare Advantage plans and this trend has caused an increase in both Medicare Advantage plans offering this coverage and enrollees having access to these supplementary benefits.

Medicare Advantage plans are private health insurance policies that combine hospital, drug and medical coverage into one package. While Medicare Advantage must offer at least the same basic coverage as Traditional Medicare (hospital stays and doctor visits), additional benefits may be included for an extra monthly fee. Medicare Advantage plans often offer more than dental benefits; you may also get prescription drug coverage, fitness programs and other services as part of their packages. You can check a plan's brochure or website to determine whether these features exist.

Medicare Advantage plans often provide comprehensive dental coverage embedded within the Medicare Advantage plan, and that’s why many seniors opt to join one. Medicare Advantage plans, which provide private health and prescription drug insurance, typically include dental coverage as an add-on or embedded benefit within the actual Medicare Advantage plan.

Medicare Advantage plans typically provide comprehensive benefits for preventive care, fillings and extractions as well as other routine procedures, but some policies have annual limits or require copayments or coinsurance payments for more extensive procedures - these costs can quickly add up if you require multiple costly services at once.

Still others make you pay for the dental services, then file with the insurance company for reimbursement!

Medicare Advantage plans have seen their share of dental coverage grow steadily over time, and that trend looks set to continue as more people move away from traditional Medicare.

However, Medicare Advantage Plans don't have to include dental coverage. These are optional benefits a Medicare insurance company may or may not include. Therefore, those looking for such coverage may need to purchase an independent, standalone dental insurance plan as a supplement to one found within a Medicare Advantage plan.

Most Medicare Advantage plans contain some type of embedded dental benefit; the exact nature and benefits scope of coverage vary by plan. It’s important to dig into the details of any embedded dental plan, as most only offer a small annual allowance, and only cover preventive services such as oral exams, cleanings and X-rays. There are usually very few dental benefit plans found within Medicare Advantage plans that cover comprehensive services such as fillings, extractions and periodontics. Finding a dental plan within a Medicare Advantage plan that cover dentures is next to impossible!

Many people would be well-served to consider buying a separate dental insurance policy separately from their Medicare Advantage plan. These plans tend to be more comprehensive in coverage.

Plus, if you buy a stand-alone dental insurance plan, the benefits travel with you, even if you someday decide to leave your Medicare Advantage plan.

Medicare Supplement (Medigap) Dental Plans in Chicago, Illinois

The second option for getting dental insurance is to buy an independent, or stand-alone dental insurance policy.

As you’ve read, Medicare Advantage plans often only provide limited coverage for dental. What’s more, the dental coverage within the Medicare Advantage plan can change annually – sometimes for the better, sometimes for the worse. And if you ever decide to enroll in a different Medicare Advantage plan, your dental benefits also change to the new plan you enrolled in.

It’s rare that Medicare Supplement plans often offer dental coverage, making them a poor option for those in need of basic or even more complex dental services. If more comprehensive coverage is desired, standalone dental insurance plans might provide better options; depending on which plan you select, some may even cover up to 100% of dentist fees or provide annual maximum benefits coverage.

But there is good news! There are also ways to buy a stand-alone, or independent dental insurance policy to provide comprehensive dental insurance coverage – surpassing even those found within Medicare Advantage plans.

Most stand-alone dental plans typically cover 100 percent of preventive care, 80 percent of basic services like fillings and crowns, and 50 percent of extensive procedures like dentures or root canals. Most plans also have annual coverage caps of around $1,500 as well as deductibles that must be met prior to receiving services. However, you can find dental plans for seniors with more than $3,000 worth of annual coverage allowances. Most have waiting periods before items like dentures, crowns or root canals are covered, but not all.

Even if you don’t want or don’t have a Medicare Advantage plan, Chicagoland Medicare offers both options to our clients and neighbors in Chicago, IL – stand-alone, independent dental insurance for people on Original Medicare Parts A and B, with or without a Medicare Supplement or Medigap plan. Chicagoland Medicare also offers Medicare Advantage plans that have dental benefits embedded within them, and we can help you select one that meets your healthcare and budget needs.

Dental Insurance and Chicagoland Medicare

Either option you choose, Chicagoland Medicare is here to help seniors find the best Medicare dental solutions for them whether they live in Chicago, Illinois or anywhere else in Illinois, Indiana or Wisconsin. It’s easy to book a free consultation or an appointment to buy Medicare dental insurance.

Dental Plans for Seniors In Chicago, IL.

It’s important to reflect and consider your personal dental health and financial situation when selecting a dental insurance plan. Most seniors do not require full coverage, but having some sort of affordable and reliable insurance coverage remains important.

Very comprehensive “Cadillac” dental insurance plans typically cover routine office visits, exams, cleanings and x-rays in addition to fillings, root canals, dentures and implants; depending on your personal requirements you might purchase either an all-inclusive plan that covers everything from cleanings and fluoride treatments through to crowns and bridges. Or you may only need a little bit of insurance coverage to maintain your health.

Sometimes, it’s possible to find dental insurance with no waiting periods, but they are rare. More often, you’ll find those embedded within Medicare Advantage plans.

Most dental insurance policies and Medicare Advantage plans with built-in dental benefits vary by state and even by county! That’s why it’s very important to understand what dental plans are available in Chicago, IL by talking to the folks at Chicagoland Medicare. We can help you uncover and understand your specific needs in Chicago, Illinois.

Do Dental Insurance Plans Have Networks?

Many dental insurance policies use networks. That means, if you use the benefits, you’ll likely be limited to opting for either a Preferred Provider Organization (PPO) or Dental Health Maintenance Organization (DHMO) plan. These types of plans feature networks of dentists who will typically offer you care at competitive costs.

However, dental insurance plans with no networks are available, so if you’re concerned about keeping your family dentist, this may be a good option for you. Chicagoland Medicare sells these types of plans, so make sure to make an appointment with us today to discuss all of your Medicare dental insurance options.

Some dental insurance plans also offer rebates or perks on non-dental services, like vision and hearing care, which also could save you money. Some also allow for optional or extra coverage such as accident and emergency protection, vision care packages and dental x-rays at an additional fee.

Again, it’s important to speak to an expert and experienced Medicare insurance agent at Chicagoland Medicare about all of the options available to you in Chicago.

Do You Need a Dental Plan?

Before purchasing a dental insurance policy in Chicago, it is crucial that you carefully assess both your individual needs and financial feasibility. Review what's covered under each plan as well as cost sharing amounts and restrictions as well as waiting periods or restrictions that might exist.

Medicare Advantage plans -- private, insurer-sponsored extensions of Original Medicare -- offer dental benefits as part of their package, making them the go-to choice for seniors seeking comprehensive protection. They feature different types of coverage with low deductibles and out-of-pocket spending caps to provide greater options to choose from.

Some DPPO and DHMO plans offer discounted dental services through networks of providers; others, known as fee-for-service plans, allow you to visit any dentist you like with the plan covering a portion of the costs while leaving you to cover the remainder yourself. While fee-for-service plans tend to be more costly, they provide greater flexibility than other types of plans.

No matter whether it's offered through a standalone policy from a private insurer, or Medicare Advantage plan with dental benefits, it is crucial that you fully comprehend your coverage and its requirements financially. Adequate dental coverage is crucial in protecting yourself against costly medical bills in the future - be sure to invest in one that suits both your needs and budget!

Medicare Advantage Plan and Dental Insurance Explained

Medicare Advantage Plans offered by private insurers like Aetna, UnitedHealthcare, Humana and Blue Cross and Blue Shield are increasingly popular with people on Medicare. These plans feature networks of providers and can help lower cost sharing like deductibles and out-of-pocket expenses; additionally, they often offer dental, vision and prescription drug coverage as added benefits.

Medicare Advantage insurance companies increase dental coverage offerings as an attempt to attract and retain existing Medicare customers while drawing in newcomers. That’s one reason why every year, more and more folks on Medicare choose Medicare Advantage plans over remaining on Original Medicare Parts A and B, with or without buying a Medicare Supplement or Medigap plan.

Since 2018, enrollment growth in Medicare Advantage plans that provide dental coverage has seen significant acceleration, though their scope remains relatively limited. If your primary care doctor recommends comprehensive dental services, it could be worthwhile investigating Medicare Advantage plans that offer these advantages.

An additional factor to consider when purchasing dental plans is their annual maximum coverage allowance. This is also known as the annual maximum dental coverage limit; currently this maximum stand at an average of only $1,300 annually. Plus, while preventive services are often covered at a $0 copay or at 100%, when you get into more comprehensive or complex dental care, most dental insurance plans only cover 70-50% of the services. That means, using the example above, if you have major dental work done at 50% coverage, you’d have to pay 50% of the entire charge up to $1,300, and then 100% of any charges above and beyond the $1,300 annual dental coverage maximum.

This is why it’s so important to understand not only what’s being offered as a dental benefit, but also what it covers and what it doesn’t. Again, for more extensive dental needs, it might be worthwhile considering purchasing either a stand-alone or independent plan or find another Medicare Advantage plan with higher limits and annual maximums.

Dental Benefits in Medicare Advantage Plans Can Change Every Year

Medicare Advantage plans must file their plan designs every year, which means they can alter their offerings every year. This means, even if the dental benefits currently embedded within your Medicare Advantage plan are satisfactory for you this year, Medicare insurance companies often alter them over the years as they look to keep premiums, medical and drug copays low.

Not only is it wise to carefully review your dental coverage found in a Medicare Advantage plan every fall during the AEP, but it’s also a good time to make sure the medical and prescription drug benefits haven’t also changed.

Speaking to an expert Medicare insurance agent like those found at Chicagoland Medicare is a good way to find help reviewing your Medicare dental insurance options, plus reviewing the annual changes to your Medicare medical and prescription drug insurance benefits.

Buying Dental Insurance Policy

Dental health is essential to overall wellbeing, yet for some individuals the cost of cleanings, x-rays, fillings, root canals and other procedures can add up quickly without proper coverage from an independent or stand-alone dental insurance plan. A Medicare Advantage plan with built-in dental benefits could be an ideal solution as well, depending on where you live and your current healthcare and financial needs.

Medicare Advantage plans typically provide some level of dental coverage, although its scope may be limited. A plan might cover basic care such as cleanings and exams but with an annual maximum benefit usually set between $1,000-$1,500; services like root canals or dentures could be excluded altogether or may have an elimination period lasting six months or longer.

When purchasing standalone dental insurance policies for seniors, be sure it meets your budget requirements and are tailored specifically to senior needs. Verifying that the preferred dentists and specialists you prefer are part of an insurer's provider network is also key.

Chicagoland Medicare can help you find if your preferred dentist is inside, or outside of any dental network. Then, we’ll do all the research for you and help you select the dental insurance plan that works best for you based on coverage, monthly premium and deductible amounts!

Make a dental insurance plan appointment with Chicagoland Medicare today!

Related Services: Medicare Supplement, Medicare Agents Near Me, Medicare Advantage, Prescription Drug Plans, Medicare Part A, Medicare Part B, Medicare Broker

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