Dental Allowance Benefit
The following benefit information applies to MVP Medicare Advantage plan members whose plan includes an allowance for dental services. See your Evidence of Coverage (your contract) or plan Riders for more information.
You will receive a separate dental ID card – show this card when you receive dental services. You can choose to go to any dentist, but generally your costs will be lower if you go to a DenteMax Medicare dentist.
Dental Benefit Highlights
Preferred Gold with Part D HMO-POS
You are covered up to $300 for any dental service per calendar year This benefit can be used for preventive and non-preventive services.
GoldSecure with Part D HMO-POS
You are covered up to $120 for preventive dental services covered by our plan per calendar year. This benefit can be used for exams, adult prophylaxis (cleaning), periodontal maintenance, and x-rays.
Gold PPO, GoldValue with Part D HMO-POS and WellSelect with Part D PPO
You are covered up to $240 for preventive dental services covered by our plan per calendar year. This benefit can be used for exams, adult prophylaxis (cleaning), periodontal maintenance, and x-rays.
- You can choose to go to any dentist. As part of your dental benefit, you also have access to the DenteMax Medicare dentist network.
- Generally, your costs will be lower if you are treated by a DenteMax Medicare dentist. DenteMax Medicare dentists accept the maximum allowable benefit amount per service as payment in full. You will not be billed for additional costs for dental services covered by the plan.
- If you choose to go to any other dentist, you may pay more. The dentist can bill you for additional costs if what they charge is more than the maximum benefit amount for preventative services covered by the plan.
Find a DenteMax Medicare dentist (For Network Type, select Medicare).
DenteMax Dental Network Providers for MVP Health Care® Medicare Advantage Plans (PDF)
MVP Health Care Out-of-Network Dental Fee Schedule (PDF)
Dental Benefit Details
- The amount MVP pays for covered services is based on the maximum allowable benefit amount for each service. If your dentist charges more than the maximum allowable benefit for a service, you may be billed for the difference.
- You are responsible for 100% of all charges that exceed the maximum allowable benefit amount, any services provided after your annual allowance is met, any dental services not covered under this benefit, or costs for services once your plan’s annual benefit amount is reached.
- No unused portion of your annual benefit amount can be carried over to the next calendar year. See your Evidence of Coverage or plan Riders for more details. If your coverage is through a former employer who has purchased additional dental coverage, see your plan Riders or contact your group for more information about your dental benefit coverage.