Best For Special Needs: Cigna
Cigna
-
Only available in 23 states
-
Dental coverage only available with some plans
We chose Cigna as best for special needs because of their personalized plan offerings. While other 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 .
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 Cignas Model of Care, the National Committee for Quality Assurance has approved Cigna to operate as a Special Needs Plan through 2021.
Cigna offers a health risk assessment 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 with premiums ranging from $0 to over $100 each month, depending on your needs and location.
What About Medicare Advantage And Dental Coverage
Medicare Advantage plans sometimes referenced as Medicare Part C may offer extra coverage that doesnt come with Original Medicare Part A and Part B, including dental care. This may include teeth cleaning, fillings, routine X-rays and extractions.
Medicare Advantage plans are offered by private insurance companies that have been approved by Medicare.
There are various types of Medicare Advantage plans, and they offer different kinds of coverage with different cost structures. If you need dental coverage of a particular type, make sure the Medicare Advantage plan youre considering offers it.
Does Medicare Cover Dental At All
The short answer to this is, in general, no, there is no Medicare dental coverage. Medicare does not cover any dental except in unique cases. Traditional Medicare does not cover dental care, dental check-ups, dental supplies or dental procedures like fillings, crowns, extractions, dentures and other services. Outpatient services and procedures are generally covered under Medicare Part B however, Part B does not cover any dental.
Medicare Part A will pay for some complicated dental surgeries or emergency procedures in limited scenarios. A few exceptions to Medicares non-coverage of dental are: extraction of teeth associated with preparation of the jaw for radiation or reconstruction of the jaw as a result of an accident.
So, if Medicare dental coverage is non-existent for all dental services and procedures, what are your options?
Recommended Reading: Do I Need To Pay For Medicare
Original Medicare Dental Coverage
Original Medicare, Part A and B, does not cover routine dental care, including:
- Cleanings and oral exams
- Bridges
- Dental appliances, including dentures or dental plates
There are a few exceptions to this. Medicare Part A may cover certain dental services performed in a hospital if its a necessary part of a covered service. For example, if you need a preliminary oral examination before a surgery or organ transplant or if you need reconstructive jaw surgery, you may be covered for these dental procedures because the care is related to another service that Medicare does cover. You may also be covered for extractions if theyre needed to prepare your mouth for radiation for oral cancer. If you receive these services as an outpatient, youd be covered under Part B.
If you need inpatient emergency hospital care because of a complication from a dental procedure, Part A will cover your inpatient hospital treatment, even if the dental services arent covered.
Keep in mind that even if Original Medicare covers a specific dental service, you may not be covered for post-treatment dental services once the specific issue has been treated. So, for example, in the case of Medicare covering reconstructive jaw surgery, it may not continue paying for dental care after that operation.
How To Sign Up For Supplemental Medicare
Supplemental Medicare plans dont have open enrollment periods like traditional Medicare does. Those eligible can sign up for plans at any time.
Use Medicares Plan Finder to locate supplemental plans in the desired area. Some applicants may be able to sign up online through the plans website. If that is not possible, they can contact the plan provider for a paper enrollment form, fill it out and return it to the plan provider. All plans offer a paper enrollment option. The plans provider will ask for a Medicare number and the date the Part A or Part B coverage started, which is found on the Medicaid card.
Once an individual finds a suitable plan, they can call the provider for more information. Those with more general questions can call Medicare at 1-800-MEDICARE .
Don’t Miss: Does Medicare Cover Dexcom G5
Why You Need A Dental Plan For Seniors
As you age, you may be at increased risk for certain dental conditions, according to the American Dental Association. Dental conditions associated with aging include dry mouth, dental caries and periodontitis, a serious gum infection. Physical and cognitive impairments may also make home oral health care difficult for seniors, exacerbating dental problems. You may wish to have a Medicare dental plan to avoid paying out-of-pocket for dental treatment.
Find More Dental Medicare Resources
If youre looking for dental insurance and wondering whether Medicare covers dental implants, the simple answer is no. Some Medicare Advantage policies may cover dental implants, but these comprehensive coverages are more expensive and are usually capped at an annual limit around $1,500. Click here for more information on Medicare dental plans.
Don’t Miss: Can Medicare Take Your House
How Can Seniors Obtain Additional Coverage For Dental Implants
Many seniors who require dental implants can expect to pay significantly for prosthesis services, plus premiums, co-insurance, co-payments, annual caps and other fees charged by their Medicare Advantage Plan. You may consider buying independent dental insurance or a discount plan if this is financially feasible. Veterans and other populations may be eligible for free or low cost dental implants through various charities and programs.
Does Medicare Cover Vision And Dental
Original Medicare does not cover routine dental or vision care. There are certain circumstances under which Original Medicare may provide some coverage for dental or vision care in an emergency setting or as part of surgery preparation.
However, you may be able to receive routine dental and vision coverage by enrolling in a Medicare Advantage plan that includes dental and vision benefits.
Read Also: Is Unitedhealthcare A Medicare Advantage Plan
How Do Medicare Advantage Plans Cover Dental Benefits
As private insurers, Advantage health insurance providers can offer a variety of benefits beyond the minimum requirements of Parts A and B of the health insurance plan, can charge additional premiums for supplements such as dental care. Businesses may also use premiums or dollar refunds to help cover the cost of these additional benefits.
Dental Crisis In United States
Nearly two-thirds of Medicare enrollees have no dental insurance at all. Thats worrisome not just for oral health, but also for overall health. Theres a significant link between untreated dental disease and various other systemic ailments, including heart disease and diabetes.
Oral cancer is seven times more likely to be diagnosed in people over age 65, and routine dental check-ups are an excellent means of detecting oral cancer.
Yet more than one in five Medicare beneficiaries have not seen a dentist in the last five years. And from 2013 to 2014, there was an increase in the percentage of elderly Americans who reported that cost was a barrier to obtaining dental care, despite the fact that all other age groups saw an improvement in this area .
About 20% of Americans age 65+ have untreated dental cavities. And about 20% of Americans age 65 and older are missing all of their natural teeth, although there is significant variation in tooth retention based on geographic area, income, and education level seniors in rural areas are especially hard hit by a lack of access to oral health care.
There is no doubt that we have a dental crisis in the U.S. And although the ACA deemed dental coverage for children to be an essential health benefit, theres no requirement that adults have dental coverage, or that insurance carriers provide it.
Recommended Reading: Can You Get Medicare If You Work Full Time
Best Online Tools: Humana
-
Website interface can be confusing
-
Not all plans come with dental coverage
Humana offers a wide variety of online tools helpful to Medicare Advantage Plan enrollees. Humanas 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 premium you can enroll in Humanas MyOption Dental – High DEN838, which includes benefits for preventive, basic, and major services at both in-network and out-of-network dentists.
Dental Coverage For Dual Eligibles
In some cases, seniors covered by Medicaid and Medicare may have access to dental benefits through Medicare Advantage plans. However, it can be quite complicated to determine which coverage options pay for certain services. Additional premiums or cost-sharing costs would also be an important factor.
Also Check: Does Medicare Pay For Dental Cleaning
Does Original Medicare Part A And Part B Cover Dental
Original Medicare is composed of Part A, which is hospital insurance, and Part B, medical insurance. The only instance in which Original Medicare might cover any dental work, is if you suffered a traumatic injury that also affected your jaw, teeth, or mouth and had to be hospitalized. Then, Original Medicare may cover some of that dental care. Understanding exactly what your plan would cover is important to know before accidents occur.
Best Customer Service: Kaiser Permanente
Kaiser Permanente
-
Dental is bundled with hearing and vision coverage
Kaiser gets our nod for best customer service based on their ratings from Medicare and from J.D. Power, the data analytics and consumer intelligence company. Kaiser came in second place in J.D. Power’s Medicare Advantage satisfaction study and missed the top spot by just one point. Founded in 1945, Kaiser Permanente is the largest not-for-profit HMO in the United States, serving 8.6 million members. People enrolled in Kaisers 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. Powers annual survey, customers rated Kaiser the overall best Medicare Advantage plan for five consecutive years , and Kaiser scored 843 in the 2021 J.D. Power Survey, a higher score than any other. Additionally, Kaiser Permanente 2022 Medicare health plans received the highest ratings from the Medicare Star Quality Ratings: 5 out of 5 stars in California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington D.C., and Washington.
Also Check: Will Medicare Pay For Cialis
Other Dental Coverage Options
Outside of getting Medicare dental benefits through a Medicare Advantage plan or a PACE program, you may find yourself having to pay the full cost for most routine dental care if youre enrolled in Original Medicare or in a Medicare Advantage plan that doesnt include dental coverage.
Dental insurance may be another option if you want help with dental costs. Keep in mind that stand-alone dental plans are not part of the Medicare program, and this coverage may come with certain costs, including premiums, deductibles, coinsurance, and copayments.
In addition, if you have limited income and qualify for Medicaid benefits, some state Medicaid programs include dental coverage. Check with your states Medicaid program to see if youre eligible for low-income assistance and if dental services are covered.
Does Medicare Part B Cover Dental
Medicare Part B does not cover any dental services. Dental insurance for seniors on Medicare is recommended in order to make sure that seniors get the routine care that they need like cleanings, exams, and fillings. Dental insurance can also help cover the cost of dentures, which Medicare typically doesnt cover.
You May Like: What Is Medicare Part A And B
Coverage Of Routine Dental Care Wasnt Built Into Medicare
Medicare was never designed to include routine dental care Medicares coverage of dental expenses is limited to situations where the dental treatment is integral to other medical treatment . Although, as noted in this brief from the Center for Medicare Advocacy, CMS has some flexibility when it comes to how the rules are interpreted.
While health insurance plans generally pick up the tab for large medical bills, its rare to find dental coverage that doesnt leave enrollees on the hook for significant bills if they need extensive dental work. This is generally true across a wide range of plan types, including Medicare Advantage dental coverage, stand-alone dental plans, and group dental plans for employees and retirees. Dental plans commonly have benefit maximums of $1,000 or $2,000 per year, and a single root canal can cost upwards of $1,500, while an implant can be as much as $7,500 per tooth.
But some coverage is better than nothing. Even with low benefit maximums, people who have dental insurance are more likely to receive routine preventive dental care, and are less likely to have untreated dental problems that get worse over time.
Do Medicare Advantage Plans Cover Dental And Vision
Medicare Advantage plans can offer coverage for dental and vision health items in addition to also offering the same coverage as Original Medicare. Most also include prescription drug coverage as well as other benefits such as hearing health coverage and gym memberships.
Medicare Advantage plans are offered by private insurance companies. The plans available to you depend on where you live. What specific dental and vision items are covered and how much they cost will vary from plan to plan.
Read Also: What Is Part B Excess Charges In Medicare
Is Dental Coverage Included In Original Medicare
If youre a senior over 65 you are most likely eligible for Medicare. Original Medicare covers hospital and medical insurance but does not generally include coverage for routine dental care such as dentures, cleanings, fillings, and extractions. Original Medicare generally only covers dental care in emergency or complicated cases. If you want coverage for routine dental care, you will most likely need a dental plan.
What Kinds Of Dentures Are Covered By Medicare Advantage
There are two types of dentures. Removable dentures are available in either a complete set of teeth or partial dentures, which cover gaps in the mouth. Implant dentures are surgically implanted in the jaw, with a titanium root and a cap that screws on top.
Medicare Advantage plans may cover both kinds of dentures or only one. Most applicants are advised to talk to a dentist who can determine which type of dentures are best for the individual and offer guidance toward the right plan.
Also Check: Where Do I File For Medicare
What Is Medicare Part C
Also known as a Medicare Advantage plan, Part C was not part of Medicare when it was established in 1965. Part C was created not as a supplement, like Medigap, but instead as an all-inclusive, bundled plan encompassing parts A, B and D. In short, it picks up where regular Medicare leaves off.
Medicare Part C is sold by private insurance companies and not only includes parts A, B and D, but adds to it the missing components of vision, hearing and dental. Because Medicare Part C is sold by private insurance companies, prices vary from company to company, state to state.
Which Medicare Advantage Plans Cover Dentures
PayingForSeniorCare is committed to providing information, resources, and services free ofcharge to consumers that help seniors and their families make better decisions about senior living and care.
We may receive business-to-business compensation from senior care partnerships and/or website advertising. This compensation doesnt dictate our research and editorial content, nor how we manage our consumerreviews program. PayingForSeniorCare independently researches the products and services that oureditorial team suggests for readers. Advertising and partnerships can impact how and where products,services, and providers are shown on our website, including the order in which they appear, but theydont determine which services or products get assessed by our team, nor which consumer reviews getpublished or declined.
PayingForSeniorCare.com awards some companies with badges and awards based on our editorial judgment. We dont receive compensationfor these badges/awards: a service provider or product owner may not purchase the award designation orbadge.
Learn moreabout our mission and how we are able to provide content and services to consumers free of charge.
Don’t Miss: How To Get Medicare For Free
Examples Of Covered Services
Part B covers a variety of outpatient services and medically-necessary preventive services.
Outpatient Medical Services
- Durable medical equipment
Preventive Services
- Cancer screenings like those for breast, colorectal, and prostate cancers
- Cardiovascular disease screenings
- Screenings for hepatitis B, hepatitis C, HIV, and STIs
- Vaccines
