Do Medicare Advantage Plans Offered by Humana Cover Routine Dental Services?
This article was updated on: 10/21/2018
If you are enrolled in Original Medicare (Part A and Part B), you may already know that it doesn’t cover routine dental care. However, if you choose to get your Medicare benefits through a Medicare Advantage plan offered by Humana, you may be able to get routine dental care coverage, depending on the plan you select. Here’s a quick overview of dental coverage offered by Humana that you may be able to add to a Medicare Advantage plan.
How does Medicare cover dental services?
Under Original Medicare, dental coverage is limited to certain procedures related to medically necessary treatment for a health condition or medical emergency. Routine dental care (such as annual exams and x-rays) is not covered under Original Medicare, nor are extractions and root canal treatments. Original Medicare may cover complex dental procedures in some situations.
All Medicare Advantage plans are required by law to offer, at a minimum, the same coverage as Original Medicare — except for hospice care, which is still covered under Medicare Part A. Offered by private, Medicare-approved insurance companies like Humana, many Medicare Advantage plans offer additional benefits – like routine dental coverage.
What dental coverage is available through Humana?
Many of Humana’s Medicare Advantage plans let you customize your health-care coverage through Humana’s Optional Supplemental Benefits program. These optional benefits include several different dental plans you may be able to choose from to add to your Humana Medicare Advantage plan. Depending on where you live, you may be able to sign up for one of the following types of Humana dental plans to work with a Humana Medicare Advantage plan. Note that the options listed below may not be available for every Medicare Advantage plan available from Humana.
- MyOptionSM Dental High or Enhanced Dental Preferred Provider Organization (PPO) plans*. These plans offer various levels of coverage for both routine dental care and more serious dental procedures, including extractions, crowns, and dentures. There may be different copayments, coinsurance amounts, and annual benefit caps depending on the plan you choose and whether you get your care inside or outside of Humana’s network of providers. MyOptionSM Dental High PPO has a $50 deductible.
- MyOptionSM Enhanced Dental Health Maintenance Organization (HMO) plans. These plans offer full coverage for routine dental care and certain other dental services, and partial coverage for certain major procedures, when care is received by providers in the Humana network.
- MyOptionSM Platinum Dental plans. These plans offer 100% coverage for routine care and partial coverage for major procedures, if you use providers in the plan’s network, and has an annual maximum benefit. The plan may provide partial coverage if you receive care outside the provider network.
- MyOptionSM Plus plans. This is an optional plan that combines coverage for routine dental and vision care with your choice of providers. MyOptionSM Plus plans have a $50 deductible, and an annual benefit maximum.
Some things to keep in mind about Medicare Advantage plans and dental coverage through Humana:
- You must continue to pay your Medicare Part B premium if you enroll in any Medicare Advantage plan, and there may be an additional monthly premium, as well, depending on the plan you choose.
- Humana dental coverage options may have a separate monthly premium.
- Not all plans may be available in all areas of the country, and not all Humana Medicare Advantage plans are eligible for optional dental benefits.
- Plans and benefits may vary by location, and plan premiums may vary depending on where you live.
- Depending on the plan you choose, your copayments, coinsurance, deductible amounts, and annual benefit maximum may vary, and you may be required to use Humana’s dental providers in order to be covered under your plan.
To learn more about Medicare and dental coverage through Humana, visit the Humana page. It’s easy to compare plans anytime by clicking “Find plans.”
*Humana is a Medicare Advantage [HMO, PPO and PFFS] organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any Humana plan depends on contract renewal. [Benefits, premiums and/or member cost-share] may change on January 1 of each year. The [Formulary, pharmacy network, and/or provider network] may change at any time. You will receive notice when necessary.
**Out-of-network/non-contracted providers are under no obligation to treat <Plan/Part D Sponsor> members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
***Humana Individual dental plans are insured or offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, The Dental Concern, Inc., CompBenefits Insurance Company, CompBenefits Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc., Humana Health Benefit Plan of Louisiana, Inc., DentiCare, Inc. (d/b/a CompBenefits), Discount plans offered by HumanaDental Insurance Company, Humana Insurance Company or Texas Dental Plan, Inc. For Arizona residents: Insured by Humana Insurance Company. For Texas residents: Insured or offered by Humana Insurance Company, HumanaDental Insurance Company, or DentiCare, Inc. (d/b/a CompBenefits).
****Humana Inc. and its subsidiaries (“Humana”) do not discriminate on the basis of race, color, national origin, age, disability, or sex.
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