Do Medicare Advantage Plans from Aetna Cover Routine Dental Services?

Last Updated : 10/21/20183 min read

There is no coverage for routine dental services under Original Medicare (Part A and Part B); however, if you choose to receive your Part A and Part B benefits through the Medicare Part C program — through an Aetna Medicare Advantage plan, for example — you might get routine dental coverage.

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Here’s what you need to know.

Does Medicare cover dental care?

If you need dental services as part of Medicare-covered inpatient hospital treatment, or you need complex or emergency dental services, Medicare Part A may cover certain services while you are an inpatient in a hospital. These services, however, are not considered routine. For the purposes of Aetna’s coverage in its Medicare Advantage plans, the following services may be considered routine:

  • Oral examinations in a dentist’s office
  • X-rays, including panoramic and bite wing views
  • Pulp vitality tests
  • Cleaning, scaling, and polishing the teeth
  • Oral hygiene consultations
  • Bite adjustments
  • Fillings and restorations (including amalgam and composite)
  • Denture adjustments
  • Extractions performed in the office (non-surgical)
  • Minor periodontic scalings and root planings

As you evaluate your Aetna Medicare Advantage plan options, you might see some of these services included in your dental coverage.

By federal law, all services covered under Original Medicare (Part A and Part B) must be covered by plans offered under the Medicare Advantage program, also known as Medicare Part C. The only exception is hospice care, which is still covered by Part A. Medicare Advantage plans offer you an alternative way to access your Original Medicare benefits, but they are administered by private health insurance companies approved by Medicare. As such, each company, including Aetna, determines which extra benefits it will cover, if any, and your out-of-pocket costs for Medicare-covered services.

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Many Medicare Advantage plans include coverage for additional services and items Original Medicare doesn’t cover, including (but not limited to):

  • Routine dental services
  • Routine vision and hearing care
  • Prescription drugs
  • Wellness programs

Also, you need to know that when you’re enrolled in a Medicare Advantage plan, you’re still in the Medicare program, and you need to continue paying your monthly Medicare Part B premium, in addition to any plan premium. You may also be responsible for a copayment or coinsurance amount when you access dental or other services.

Keep in mind that not all plans may be offered in every city and state, and that benefits beyond Original Medicare – as well as costs – may vary from one Aetna Medicare Advantage plan to another. It’s also important to note that coverage may depend on staying with your plan’s network of preferred providers; your out-of-pocket costs may be higher if you go out-of-network for your care.

If you’d like more information about routine dental coverage and your Aetna Medicare Advantage plan options, visit the Aetna Medicare page.

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