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Medicare Advantage and dental coverage

Find out what is covered

This article was last updated Nov. 8, 2023.

Something people may look forward to when reaching age 65 — commonly thought of as retirement age in the U.S. — is becoming eligible to enroll in Original Medicare, which is health care coverage for seniors provided by the federal government.

Original Medicare is divided up into two parts: Part A and B. Participants can also enroll in additional coverage — Part C and Part D — from private insurers.

  • Medicare Part A — Hospital care
  • Medicare Part B — Doctor visits
  • Medicare Part C — Medicare Advantage
  • Medicare Part D — Prescription drugs

Parts A and B are what’s known as Original Medicare. Part C refers to Medicare Advantage plans, which is comprehensive coverage similar to employer-provided health insurance. Part D covers the cost of prescription drugs and is added to Original Medicare to round out coverage.

While Original Medicare provides coverage for several essential health care services — such as hospital visits and wellness checks — there are several gaps in coverage that Original Medicare doesn’t cover, including vision, hearing and perhaps most importantly, dental care. That’s where Medicare Advantage can help.

The importance of dental care for seniors

Good dental hygiene is important for all ages but can impact your health and comfort as you age. Simple practices like regular brushing and flossing can not only help you maintain healthy-looking teeth and fresh breath but can reduce your risk for dental problems.

Without regular oral health care, you could be at a higher risk for gum disease, tooth decay and other serious dental and gum health issues. Poor dental health can even lead to complications such as oral cancer or heart disease. Regular check-ups with your dentist can help you stay ahead of issues and manage the risks.

Luckily, a Medicare Advantage plan can help you pay for the dental services needed to support your overall health. Wellmark Advantage Health Plan offers Medicare Advantage plans to eligible Iowans and South Dakotans.

Do Medicare Advantage Plans cover dental services?

Yes! Medicare Advantage plans offer affordable preventive and comprehensive services not covered by Original Medicare. Dental benefits in a Blue Medicare AdvantageSM plan are provided by Delta Dental® of Iowa and Delta Dental® of South Dakota.

Here’s a list of common dental care services included in a Blue Medicare Advantage plan.

Preventive dental services

  • Oral exams
  • Bitewing radiographs
  • Full-mouth series X-ray/panoramic film*
  • Other diagnostic imaging (periapicals)
  • Dental prophylaxis

Comprehensive dental services**

  • Resin based composites
  • Crown repairs
  • Onlays and crowns
  • Endodontics (root canals)
  • Perio cleanings
  • Perio surgical procedures
  • Perio non-surgical procedures
  • Dentures
  • Denture relines/repairs
  • Implant services
  • Implant repairs
  • Bridges
  • Bridge repairs
  • Simple extractions
  • Surgical extractions/oral surgery
  • Brush biopsy

How to enroll in Medicare Advantage for dental services

Dental benefits are included in your Medicare Advantage plan. You can enroll in a Medicare Advantage plan during a designated enrollment period.

Enrollment periods

If you’re just turning 65 years old or losing group health insurance coverage due to retirement, there are a couple Medicare enrollment periods to be aware of. During these periods, you can enroll in Original Medicare or additional coverage, like a Medicare Advantage plan from Wellmark Advantage Health Plan.

  • IEP: Initial Enrollment Period — Seven months surrounding your 65th birthday.
  • SEP: Special Enrollment Period — After any qualifying life event.
  • AEP: Annual Enrollment Period — After your Initial Enrollment Period, you can make changes to your coverage during AEP, which happens Oct. 15 to Dec. 7.

Take care of your teeth

As we age, our teeth remain a vital part of our overall health and well-being. A Medicare Advantage Plan from Wellmark Advantage Health Plan could be your key to securing dental care coverage as a senior.

What else is covered in Medicare Advantage plans?

In addition to both preventive and comprehensive dental services, Medicare Advantage plans provide coverage for other services Opens in a new window that Original Medicare plans do not. With a Blue Medicare Advantage plan, you get extra benefits, like:

  • SilverSneakers®: Gain access to local fitness center classes and online resources.
  • Hearing: Pay nothing for an annual hearing exam and hearing aid fitting, plus an allowance toward the cost of hearing aids.
  • Vision: Enjoy a $0 copay for a routine eye exam, plus an allowance for glasses or contacts.
  • Over-the-counter (OTC) products: Get a quarterly allowance to spend on more than 300 OTC health products.
  • Personal emergency response system (PERS)***: Feel protected with an emergency response device and 24/7 monitoring.

Blue Medicare Advantage plans also offer no or low-cost care options, including:

  • 24/7 nurse line: Call anytime, day or night, for answers to basic heath questions.
  • Doctor On Demand®: Visit with a physician quickly and virtually on your schedule.
  • No-cost wellness appointments: Schedule same-day or next-day appointments with primary care provider (PCP) provider at no cost. That means a $0 copay for PCP visits.

Frequently asked questions about Medicare Advantage and dental

Does Medicare Advantage cover dental?

While Medicare Advantage plans vary by provider, all Medicare Advantage plans from Wellmark cover dental services. Coverage and services vary by plan.

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Does Medicare cover periodontal disease?

While Original Medicare does not cover periodontal disease, Blue Medicare Advantage plans do cover periodontal disease. The periodontal region is made up of the structures that directly support the teeth, including gums. Original Medicare may indirectly cover the treatment of periodontal disease if it’s related to care or illnesses covered under Part A or B.

Does Medicare cover root canals?

No, Original Medicare does not cover root canals. However, you can purchase a Medicare Advantage plan from private health insurance companies like Wellmark to get root canal coverage, along with other dental services.

Does Medicare Advantage cover dentures?

Coverage may vary by dental provider, but Medicare Advantage plans from Wellmark provide coverage for dentures.

Does Medicare Part C cover dental?

Medicare Part C is another name for Medicare Advantage. Wellmark’s Medicare Advantage plans cover dental services.

Still have questions about Medicare Advantage?

We're here to help. If you live in Iowa or South Dakota, call us directly at . If you live outside Iowa or South Dakota, visit Blue Cross Blue Shield Association External Site.

*Available only on the Blue Medicare Advantage Enhanced plan.

**While many preventive services have a $0 copay, comprehensive services may be subject to a coinsurance. Wellmark Advantage Health Plan offers plans with different levels of dental coverage.

***Available through select Blue Medicare Advantage PPO plans.

Wellmark Advantage Health Plan is a PPO and HMO plan with a Medicare contract. Enrollment in Wellmark Advantage Health Plan depends on contract renewal.

Wellmark Advantage Health Plan, Inc. is an independent licensee of the Blue Cross and Blue Shield Association.

SilverSneakers® is a registered trademark of Tivity Health, Inc. © 2023 Tivity Health, Inc. All rights reserved. Tivity Health, Inc. is an independent company that provides health and fitness programming on behalf Wellmark Advantage Health Plan, Inc.

Dental benefits provided by Delta Dental® of Iowa and Delta Dental® of South Dakota. These are independent companies providing dental services on behalf of Wellmark Advantage Health Plan, Inc.

Y0156_Med24Dentl_M CMS Accepted 11202023