If visiting the dentist is not your favorite task, you’re not alone. About one in six seniors describe their oral health as “poor,” and about one in four seniors of Medicare age (65 and over) have gone five years or more since their last dental visit, according to the National Institute of Dental and Craniofacial Research (NIDCR).
Original Medicare—Medicare Part A (hospital insurance) and Medicare Part B (medical insurance)—doesn’t cover routine dental care, such as cleanings, fillings, crowns, and dentures. It may cover certain dental expenses related to surgery or as part of an emergency. If you have Original Medicare and want dental coverage, however, you can buy a separate dental plan or enroll in a Medicare Advantage Plan, also known as Medicare Part C, that includes dental benefits.
Medicare Advantage Plans bundle together Medicare services such as Medicare Part A, Medicare Part B, and often Medicare Part D (prescription drug benefit). Many plans also include other coverage such as dental, vision, and hearing According to the Kaiser Family Foundation (KFF), a non-profit organization focusing on national health issues, 67% of Medical Advantage Plan enrollees have a dental benefit.
Plans and Pricing
Medicare Advantage Plans are available through private companies approved by Medicare. Prices and coverage for Medicare Advantage plans vary widely; one insurance company’s prices can be different from state to state and county to county. When shopping for a Medicare Advantage plan with dental coverage, make sure that the plan covers the dental services that are most important to you. This could include routine dental exams, X-rays, gum disease treatment, fillings, or dentures.
Signing up for Medicare can be a complicated process, so we have outlined the basic steps below. Here are some tips to help you sign up for the best dental plan for you from the Medicare Advantage plan options.
Step 1: Find a list of Medicare Advantage plans available in your area.
Using Medicare’s Find a Medicare Plan tool, you can log in without an account, choose a Medicare Advantage Plan, type in your ZIP code, and follow the simple instructions to get a list of the available plans.
Step 2: Review the plans available in your area.
Under “Plan Benefits,” a green checkmark next to “Dental” indicates plans that include dental coverage.
Along with benefits, you will see other useful information, such as monthly premiums, the yearly maximum you pay for health costs, and the type of plan, such as:
· HMO (health maintenance organization)
· HMO-POS (health maintenance organization—point of service)
· PPO (preferred provider organization)
· PFFS (private fee-for-service)
· SNPs (special needs plans)
Step 3: Find the plans with features that fit your needs.
The “Plan Details” button helps you learn more about the coverage offered, such as preventative dental (exam, cleaning, X-rays) or comprehensive dental (extractions, periodontics, restorative services).
Step 4: Visit the websites of the companies offering the plans.
You can look at the details of each plan, and many company websites allow you to see if your dentist accepts the plan.
Step 5: Consider talking to a broker or consultant.
Good resources include the State Health Insurance Assistance Programs at 877-839-2675 or call Medicare at 800-MEDICARE (800-633-4227) to get answers to questions not answered in your research.
Step 6: Sign up.
Medicare provides excellent online resources including details about enrollment periods for Medicare Advantage Plans.
The 6 Best Dental Insurance for Seniors on Medicare in 2020
Medicare Advantage enrollment is highly concentrated among a small number of providers. To help you choose a Medicare Advantage Plan that includes dental coverage, we have researched the top offerings. The criteria we used included availability, pricing, website usability, and the Medicare Star Rating System. Here are our top picks.
Best Overall: United Healthcare
Access to additional AARP programs and services
Plan overview uses easy-to-understand icons, such as a tooth for dental coverage
More in-network dentists (about 180,000) than any other insurance carrier offering Medicare plans
Doesn’t have all plans (HMO, HMO-POS, PPO) in all the markets in which they offer plans
United Healthcare, founded in 1977, was chosen as best overall based on its popularity and its affiliation with the American Association of Retired People (AARP). Of the 22 million people enrolled in Medicare Advantage Plans in 2019, United Healthcare covers 25%, more enrollments in their Medicare Advantage Plans than any other company.
More than 82% of Medicare beneficiaries have access to at least one United Healthcare plan (according to KFF), and United Healthcare services ranked fourth in overall customer service in a 2020 J.D. Power study (800 points out of 1,000).
Their full range of plans (HMO, HMO-POS, PPO, etc.) has premiums ranging from $0 to over $100 each month, depending on your needs and location. If you choose United Healthcare, you also receive access to additional AARP programs and services such as discounts on shopping and travel, savings on home and auto insurance, and free financial advice.
Best Customer Service: Kaiser Permanente
Silver & Fit fitness program
Informational resources, such as videos, seminars, FAQs, and glossary
Only in eight states and Washington, D.C.
Difficult to find links to plans on website
Dental coverage is extra (Advantage Plus) and is only available grouped with hearing aid and eyewear coverage
Kaiser gets our nod for best customer service based on their ratings from Medicare and J.D. Power, the data analytics and consumer intelligence company. Founded in 1945, Kaiser Permanente is the largest managed care organization in the United States. People enrolled in Kaiser’s Medicare Advantage plan can get coverage at any Kaiser Permanente facility, and premiums range from $0 to over $100 each month, depending on your needs.
With many of their Medicare Advantage Plans, Kaiser offers the Silver & Fit senior fitness program. The program is offered with a facility-based option and a home-based option and includes educational materials on healthy aging, social activities, and an activity and exercise tracking tool.
In J.D. Power’s annual survey, customers rated Kaiser the overall best Medicare Advantage plan for five consecutive years (2015–2019). In 2020, Kaiser’s Medicare health plans received high ratings from the Medicare Star Rating System: 5 out of 5 stars, in California, Colorado, Georgia, Hawaii, Maryland, Virginia, and Washington D.C., and 4.5 out of 5 stars in Oregon and Washington.
Best Online Tools: Humana
More than 85% of Medicare beneficiaries have access to at least one Humana plan
SilverSneakers fitness program
With some programs, additional dental benefits may be available, with a separate monthly premium
Easy to fine-tune estimated premium by adding in medications list
Website interface gets sidetracked with secondary searches, such as checking to see if your doctors are in network
Humana offers a wide variety of online tools helpful to Medicare Advantage Plan enrollees. Humana’s RXMentor helps enrollees keep a complete, up-to-date list of their medications. Their MyHumana app offers fingerprint sign-in for access to ID Cards, drug pricing, claims, and in-network providers. Their Go365 program and app allow you to earn, track, and redeem points for completing healthy actions. These are the kinds of useful website features that made Humana our pick for best online tools.
Humana also offers SilverSneakers, a health and fitness program for seniors that includes gym access, classes, and the SilverSneakers Go fitness app for tracking and scheduling activities.
With some of their Medicare Advantage plans, Humana offers an option for additional dental coverage. For example, if you are located in Dallas, Texas, and enroll in the Humana Gold Choice PFFS plan, you have a $45 copay for in-network dentist visits and a $50 copay for an out-of-network dentist for Medicare-covered dental services. For an additional $15.10 premium you can enroll in Humana’s MyOption Dental - High DEN838, which includes benefits for preventive, basic, and major services at both in-network and out-of-network dentists.
Founded in 1961, Humana has Medicare products available in Washington, DC, and all states except Massachusetts, Minnesota, and Wisconsin. They have a full range of plans (HMO, PPO, PFFS, etc.) with premiums ranging from $0 to over $100 each month, depending on your needs and location.
Best National Coverage: Aetna
Easy-to-understand explanation of differences between types of plans (HMO, PPO, etc.)
Prescription drug home delivery
Concierge service to help understand and access your plan
24/7 registered nurse available by phone
Website offers choice between guided and self-tour of plan options
Dental coverage is not indicated in the plan summary on the website
Doesn’t offer all plans (HMO, HMO-POS, PPO) in all the markets they cover
We chose Aetna as best for national coverage for its operations in all 50 states plus the District of Columbia and Puerto Rico. Aetna has approximately 12.7 million dental members, and their network includes about 1.2 million health care professionals, with over 700,000 primary care doctors and specialists and over 5,700 hospitals.
With many of their Medicare Advantage plans, Aetna offers home delivery of most prescription drugs through their mail-order pharmacy: CVS Caremark. Aetna also offers a concierge program with many of its Medicare Advantage plans. An Aetna concierge can help you manage your health care expenses, understand your benefits, locate providers near you, and help plan for treatments.
Founded in 1853, Aetna, has a full range of plans (HMO, PPO, EPO, etc.) with premiums ranging from $0 to over $100 each month, depending on your needs and location.
Best for Potential New Offerings: WellCare
Website offers easy plan coverage comparison for up to 3 plans
Many plans include OTC items
Some plans include personal emergency response system access
Website has easy-to-use pharmacy finder/drug finder/physician finder
Website requires detailed information (age range, health status) to review plans
While many competitors include additional coverage, such as dental, on their online plan summaries, the WellCare website requires clicking and scrolling to find plan details
Founded in 1985, WellCare is a relative newcomer. We picked them as one to watch for potential new offerings in their Medicare Advantage Plans for two reasons: In 2019, WellCare acquired Aetna’s Part D prescription drug plan (PDP) and in 2020, they were acquired by Centene, one of the largest providers of Medicaid. This recent activity could result in new Medicare Advantage Plan offerings that address specific pricing or feature needs.
Benefits offered with some WellCare Medicare Advantage Plans include over-the-counter coverage (OTC) and access to a personal emergency response system. The OTC benefit is a fixed dollar amount for non-prescription medications and wellness-oriented items that can be shipped directly to you. The personal emergency response system, for people who live alone or are left alone for long periods, is connected to your phone and allows you to get emergency help with the push of a button.
WellCare Medicare Advantage Plans are available in 25 states. They have a full range of plans (HMO, PPO, EPO, etc.) with premiums ranging from $0 to over $100 each month, depending on your needs and location.
Best for Special Needs: Cigna
Performs a health risk assessment to help identify your health care needs
Website offers search by zip code or county of residence
Medicare Star Rating is shown on both the summary and the details of each plan
Fails to mention dental coverage in the plan summary, excessive additional clicking and scrolling required
Medicare Advantage Plans only offered in 18 states
We chose Cigna as best for special needs because of their personalized plan offerings. While some Medicare Advantage Plans limit coverage to individuals with special health conditions or care needs, Cigna offers special needs plans that include access to a wider range of specialists, along with regular health assessment (beyond annual physicals and care transition assistance).
Depending on your health care needs, Cigna offers an increased range of services, whether that is more intensive treatments, personalized care treatments, or more individual specialist attention.
Based on a review of Cigna’s Model of Care, the National Committee for Quality Assurance (NCQA) has approved Cigna to operate as a Special Needs Plan (SNP) until 2021.
Cigna offers a health risk assessment (HRA) that can be used to develop personalized care plans with Cigna Medicare Advantage Plan enrollees and their primary care doctor. The HRA also helps match each enrollee with the health and wellness services that best fit their needs.
Originally founded in 1792 as the Insurance Company of North America, Cigna is now an American worldwide health services organization. They have a full range of plans (HMO, PPO, EPO, etc.) with premiums ranging from $0 to over $100 each month, depending on your needs and location.
How Much Does a Medicare Advantage Plan With Dental Coverage Cost Out-of-Pocket Over the Monthly Premium?
Typically, copayment or coinsurance for most Medicare Advantage Plan dental coverage, such as 50% coinsurance or a $50 copayment. Also, many plans cap the annual coverage amount. That being said, plans are different between providers and even between plans offered by the same provider. You should check the costs associated with your dental coverage before committing to a plan.
Is a Medicare Advantage Plan the Only Way to Get Dental Coverage With Medicare?
No, no matter what type of Medicare coverage you have you can purchase a dental-only insurance plan. There are a variety of plans available offering different levels of coverage, premiums, copays, and spending caps. Examples include Delta Dental, Humana, and others.
What Are the Benefits of Buying a Medicare Advantage Plan?
Some people prefer a Medicare Advantage Plan because it bundles all coverage under one plan that often includes a prescription drug program and added benefits such as dental, vision, and hearing care. Also, many prefer a lower monthly premium (sometimes $0) based on how they feel they will access the coverage.
How Much Does a Medicare Advantage Plan Typically Cost?
According to the Centers for Medicare & Medicaid Services in 2018, the average Medicare Advantage monthly premium was $30, although the monthly premiums for a Medicare Advantage Plan can range from $0 to over $100. There are also out-of-pocket costs such as copayments and coinsurance. For some plans, out-of-pocket costs can also be impacted by going to doctors who are out of network.
Some plans have a yearly limit on your out-of-pocket costs for all medical services. For example, if you live in Dallas, Texas:
- The United Healthcare AARP Medicare Advantage (HMO-POS) has a $0 monthly premium and a $3,400 out-of-pocket maximum
- The HumanaChoice PPO has an $18 monthly premium and a $6,700 out-of-pocket maximum ($10,000 combined in- and out-of-network)
- The Cigna-HealthSpring (HMO) Preferred has a $0 monthly premium and a $3,900 out-of-pocket maximum (applies to in-network Medicare-covered benefits)
While you might be attracted to the perceived lower price, be sure to check the coverage to make sure that you are getting the care you want and need, without incurring additional costs that may offset the upfront savings.
Can My Coverage Change?
Every January Medicare Advantage Plans can change their costs and their coverage for the new calendar year. You should review your coverage and compare your plan with other available plans to make sure you have the coverage you need at the best possible price.
How We Chose the Best Dental Insurance for Seniors on Medicare
For this ranking, we looked at over two dozen Medicare Advantage Plan providers and almost 100 individual plans. Key considerations included Medicare’s CMS Star Rating, J.D. Power customer service ratings for Medicare Advantage Plan providers, and geographic availability (number of states plan is available), as well as website interface, navigation, and usability. We also considered any additional benefits providers offer upon enrolling, such as health and wellness plans or home delivery for prescriptions.
National Institute of Dental and Craniofacial Research (NIDCR). "Treatment Needs in Seniors (Age 65 and Over)." Accessed August 11, 2020.
Kaiser Family Foundation. "A Dozen Facts About Medicare Advantage in 2019." Accessed August 11, 2020.
J.D. Power. "Medicare Advantage Plans Struggle to Communicate Effectively with Members." Accessed August 11, 2020.