News and Views

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Medicare Advantage plans

Wednesday, April 13, 2022 | Posted in GEHA Connection Dental Network Provider Newsletter

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Medicare Advantage plans offer expanded coverage, but verify benefits first

Regular dental care is an important part of maintaining good health. One of the main perks of a Medicare Advantage plan is that many plans offer dental coverage.

Traditional Medicare only covers dental procedures while in the hospital. Medicare Part A does not cover routine dental care, such as cleanings, X-rays and fillings. Because of high out-of-pocket expenses, patients enrolled in traditional Medicare often go without the services they need. Medicare Advantage (Part C) is an all-in-one alternative to traditional Medicare. Medicare Advantage is a bundled plan that includes Parts A, B and usually, D. Medicare Advantage offers extra benefits that traditional Medicare does not, such as dental, vision, hearing and more. Patients that have Medicare Advantage plans may pay additional premiums for coverage.

Medicare plans include:

Part A (Inpatient hospital coverage)
Part B (Outpatient medical coverage)
Part C (Medicare Advantage)
Part D (Prescription drug coverage)

Medicare Advantage plans include a variety of dental benefits. Please note you will be reimbursed by the payor the member has selected, not by Medicare directly.

It is crucial to verify benefits and eligibility with each payor prior to performing services. Contact the payor directly for your participation status within each of their network plans or products.

For a full listing of Medicare Advantage payors and plans, please visit the Resource Center at connectiondental.com

Look in the Resources box on the right, then scroll near the bottom to the Connection Dental Network Payor List.

Since these plans follow Medicare/Medicare Advantage guidelines, you will need to comply with related requests sent by GEHA Connection Dental Network, including annual fraud, waste and abuse training and quarterly directory updates. Both tasks can be completed at connectiondental.com within the Provider Portal. You will receive a prompt to complete your training when required.