Do Anthem Medicare Plans Cover Routine Dental Services?
This article was updated on: 10/21/2018
If you’re a Medicare beneficiary looking for dental coverage, you may be interested in Anthem Medicare Advantage plans or Anthem Extras plans. Here’s what you need to know about these plans.
Does Medicare dental coverage apply to routine care?
Under Original Medicare (Part A and Part B), there is no coverage for preventive or routine dental care services. The only Medicare dental coverage under Part A and Part B is for medically necessary care for an injury or disease that affects the teeth or jaw. The following services, for example, would not typically be covered:
- Annual or semi-annual routine exams
- Bite wing or panoramic x-rays taken during routine care
- Cleaning and polishing
- Scaling and periodontal services
- Crowns, bridges, and other restorations
- Dentures and denture fittings
- Bite adjustments
- Root canal treatments
If you’d like Medicare coverage for these services, there are a couple of different ways you might be able to get these benefits through Anthem plans.
- In some parts of the country, you may be able to sign up for an Anthem Medicare Advantage plan. Through the Medicare Advantage (Medicare Part C) program, you can get your Original Medicare benefits through a private insurance company, like Anthem, that contracts with Medicare. Hospice services are still covered under Medicare Part A. Some Anthem Medicare Advantage plans may cover routine dental services.
- You can apply for an Anthem Medicare Extras plan. You can apply for this plan alone, or in some cases it can work alongside your Anthem Medicare Supplement (Medigap) plan. Read more about Medicare Supplement plans. Anthem is a private insurance company contracted with Medicare to provide health-care benefits. Anthem Extras plans don’t work with Medicare Advantage plans.
In either case, you need to be enrolled in Medicare Part A and Part B and live in the plan’s service area. You also need to continue paying your Medicare Part B premium.
Do Anthem Extras plans offer routine dental coverage?
There’s a range of benefits offered by the various Anthem Extras plans. Each of the plans described below offers dental coverage – some plans are more comprehensive and some are more basic. All of these packages include vision coverage except the Premium Plus Dental Plan, and some cover other additional benefits, such as support resources for older adults.
- Premium Plus Package – covers all your diagnostic and preventive dental care; 80% of minor restorative services (after a 6-month waiting period); 50% of crowns, dentures, and bridges (after a 12-month waiting period); and more
- Premium Package – covers all your diagnostic and preventive dental care, 80% of minor restorative services (after a 6-month waiting period), and more
- Standard Package – covers all your diagnostic and preventive dental care with no deductible
- Premium Plus Dental Plan (dental only) – covers all your diagnostic and preventive dental care; 80% of minor restorative services (after a 6-month waiting period); 50% of crowns, dentures, and bridges (after a 12-month waiting period)
These plans allow you to choose the additional benefits you need to manage your health-care expenses. Anthem Extras Packages offer varying levels of coverage, copayments, and annual benefit maximums for the following:
- Basic preventive dental
- Comprehensive dental
- Vision care
- SilverSneakers wellness program
- Older adult care
- Travel assistance
Some things to remember about Anthem Extras Packages:
- Not all plans may be available in all locations, and plan benefits may vary from place to place.
- You must continue to pay your Part B premium plus any additional monthly premium your plan requires. Plan premiums may vary by location and coverage options.
- You may be responsible for deductibles, copayments, and/or coinsurance amounts when you access your Anthem Extras plan Your out-of-pocket expenses may differ depending on whether you use in-network or out-of-network providers.
- You must use your Anthem Extras plan ID card when you receive health-care services.
If you would like to add dental services to your Medicare coverage, you can learn more about Anthem Medicare Advantage Plans by using the Find Plans button on this page.
Anthem Blue Cross and Blue Shield serves Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), and Wisconsin.