While Medicare benefits under Original Medicare fall short for certain types of coverage, there are ways to plug the gaps. Even if the coverage is sufficient today, there may be a need for more in the future. Waiting to look at all the options runs the risk of missing the open enrollment period when coverage can be changed without repercussion. Hence, many people elect to enroll in Medicare Advantage or Medicare Supplement insurance. Vision care and dental services are two examples of Medicare benefits where Original Medicare leaves a void.
Medicare may cover some dental services rendered in a hospital under Part A, such as urgent or complex dental procedures. However, Medicare benefits not covered include routine dental care, including cleanings, fillings, extractions, dentures and dental plates.
Humana dental coverage for Medicare recipients
There are several dental plans on the market available for purchase through private insurance companies. Humana is one of the largest carriers offering dental insurance. On the Humana website, the company describes multiple plan types to meet the needs of its subscribers and accommodate different budget levels, ranging from Preferred Provider Organization (PPO) and Dental Health Maintenance Organization (DHMO) to discount and value plans. Availability, cost and benefits of these plans vary by state.
Humana Medicare Advantage and Supplement Plans
Medicare recipients enrolled in Humana’s Medicare Advantage plans may be able to add optional supplemental benefits (OSBs) for an additional monthly premium to be covered for routine dental care, such as cleanings and X-rays. Humana’s overarching program for these Medicare Advantage add-on plans is aptly named MyOption. These plans vary in levels of coverage, services and parameters, clearly represented by such descriptive plan names as Dental High, Enhanced, Platinum, Enriched and Total.
Some of Humana’s Medicare Healthy Living supplemental plans cover dental care to the extent of 100% of two routine exams and cleanings, one bite-wing X-ray, 50% coverage on fillings and 75% coverage for extractions.
Asking the right questions
When comparison shopping, remember to ask questions beyond the dental services covered. Inquire about copayments and discounts as well as the annual deductible and annual benefit maximum. Also, check if you can visit an out-of-network dentist for a lesser benefit or if it is mandatory to use a dentist in the insurer’s network. If you wish to continue using your personal dentist, confirm in-network status with the carrier as well as the dentist.