Medicare Advantage plans typically cover preventive care such as annual cleanings without cost-sharing, but more extensive dental services often require enrollees to pay a portion of their care. or not covered at all.
Plans also typically cap how much they’ll pay for care in a year, with more than half of Advantage enrollees in a plan with a maximum dental benefit of $1,000 or less, including amounts spent on preventive care, according to KFF.
Lipschutz said a woman whose organization she works for has an Advantage plan with a $2,500-a-year cap on dental care.
When she was treated for an oral infection, her services, including X-rays, were not covered, despite the dentist and plan to tell her that it was.
“Even if you have a generous out-of-pocket cap, it doesn’t mean most of the dental care you need will actually be covered,” says Lipschutz.