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THE SCOOP ON MEDICARE ADVANTAGE "FREE" DENTAL INSURANCE - Read below for our view
Update 12/9 - I spoke with a Medicare insurance agent yesterday who did not know anything about a plan he just sold, except that it had $4000 in benefits. He didn't know fee schedules or what the plan covered! I asked him why he sold the person the plan if he didn't know anything about it. He didn't have an answer...
It seems every other commercial on TV advertises 100% free dental coverage with a Medicare Advantage Plan. We deal with insurance companies every day, and we try to let our patients know what is what, when it comes to dental insurance.
Like regular insurance companies, there are hundreds of different plans from several insurance companies that carry dental with Medicare. Plans can come with different deductibles, no deductibles, different maximums, different monthly costs, waiting periods for certain procedures, etc. Some even force you go to only specific "in network" doctors, and they don't tell you that.
Insurance companies advertise 100% coverage for fillings, dentures, crowns, cleanings, etc. The catch is that they may cover a percentage, or 100%, of their allowable fee. Their “allowable fee” is usually much less than a dentist’s fee, and sometimes even half of a normal and customary fee from any dental office.
Operators at insurance companies talk in percentages, not in dollars, so they will tell you that you have no deductible, $1000 maximum per year, and they pay 100% of your new dentures (for example). In reality, dentures cost anywhere from $1200 to $1700, and one insurance company we deal with has a denture allowance of $325, of which they will pay 100%! We had a patient call the company back to get clarification and they still told her 100% and she insisted she could come in for free dentures.
So, no free lunch… We recommend going through an agent, get dollar amounts allowed, maximums, deductibles, waiting periods, and printed details with everything you want to know about the plan, especially the allowable dollars for different procedures.
We do file with Medicare, and are happy to help you whether you are our patient or not. We don’t know everything but we can steer you in the right direction.
It seems every other commercial on TV advertises 100% free dental coverage with a Medicare Advantage Plan. We deal with insurance companies every day, and we try to let our patients know what is what, when it comes to dental insurance.
Like regular insurance companies, there are hundreds of different plans from several insurance companies that carry dental with Medicare. Plans can come with different deductibles, no deductibles, different maximums, different monthly costs, waiting periods for certain procedures, etc. Some even force you go to only specific "in network" doctors, and they don't tell you that.
Insurance companies advertise 100% coverage for fillings, dentures, crowns, cleanings, etc. The catch is that they may cover a percentage, or 100%, of their allowable fee. Their “allowable fee” is usually much less than a dentist’s fee, and sometimes even half of a normal and customary fee from any dental office.
Operators at insurance companies talk in percentages, not in dollars, so they will tell you that you have no deductible, $1000 maximum per year, and they pay 100% of your new dentures (for example). In reality, dentures cost anywhere from $1200 to $1700, and one insurance company we deal with has a denture allowance of $325, of which they will pay 100%! We had a patient call the company back to get clarification and they still told her 100% and she insisted she could come in for free dentures.
So, no free lunch… We recommend going through an agent, get dollar amounts allowed, maximums, deductibles, waiting periods, and printed details with everything you want to know about the plan, especially the allowable dollars for different procedures.
We do file with Medicare, and are happy to help you whether you are our patient or not. We don’t know everything but we can steer you in the right direction.
