New! Enhanced Dental Coverage through the Delta Dental Network!
You're covered for a wide variety of services including cleanings and exams as well as extractions, root canals, bridges, crowns and dentures on most plans! And, we've increased our annual maximum to $2,000 per calendar year on most of our plans. Supplemental dental coverage can be purchased for an additional $35 monthly premium.
Preventive and Comprehensive Dental Coverage
Included with all plans
Through our partnership with Delta Dental of Ohio, this coverage includes access to the Delta Dental Medicare Advantage PPO Network and features the following benefits:
- $0 office visit copay
- Two cleanings
- Two exams
- One bitewing x-ray per year
- Full mouth or panoramic x-rays once every five years
- Periapical x-rays as needed
- Emergency treatment of dental pain as needed
- Filings:
- You pay 30% coinsurance for filings with the Topaz (HMO) and Jade (HMO) Plans
- You pay 50% coinsurance for filings with most other plans
NEW for 2023!
Most plans now offer coverage for bridges, crowns and dentures:
- You pay 50% coinsurance for bridges, crowns and dentures with the Topaz (HMO) and Jade (HMO) Plans
- You pay 70% coinsurance for bridges, crowns and dentures with the Amber (HMO), Garnet (HMO), Sapphire (HMO-POS) and Emerald (HMO-POS) Plans
- The Ruby (HMO) Plan doesn't offer coverage for bridges, crowns and dentures
For most plans, you are covered for a maximum of $2,000 per calendar year for dental services. For the Ruby (HMO) plan, you are covered for a maximum of $500 per calendar year for dental services.
Exclusive to the Garnet (HMO) plan
Through our partnership with Delta Dental of Ohio, the Garnet (HMO) Plan includes access to both the Delta Dental Medicare Advantage PPO and Medicare Advantage Premier Networks and features all the benefits above plus dental coverage for:
- You pay $0 for fillings, non-surgical periodontic services, simple extractions and root canals
Dental coverage under the Garnet (HMO) Plan has a $2,000 calendar year maximum.
Optional Supplemental Dental Coverage
If you elect to enroll in our optional supplemental dental plan, you’ll pay an additional $35 per month in order to obtain the following additional benefits. You must keep paying your Medicare Part B premium and your SummaCare Medicare plan premium. The optional supplemental dental coverage has a calendar year maximum of $2,000.
Major Restorative Services (You pay 50% coinsurance):
- Crowns and onlays
- Relines and repairs to bridges and dentures
- Crown repair*
- Surgical periodontics*
- Other oral surgery – dental surgery, excluding simple extractions*
Minor Restorative Services (You pay 50% coinsurance):
- Fillings
- Root canals
- Periodontal services (surgical and non-surgical)
- Extractions and oral surgery
Things to note:
- If you purchase this optional supplemental dental benefit, the plan will pay a total maximum benefit of $2,000 per benefit year. This includes your preventive and supplemental dental benefits.
- Services must be received through the Delta Dental Medicare Advantage PPO and Medicare Advantage Premier Networks.
- Services received from dentists who do NOT participate in the Delta Dental Medicare Advantage PPO and Medicare Advantage Premier Networks are NOT covered benefits.
