Dental Benefits Included With All Plans
Dental care is key to your overall health. And dental coverage is something you want in your Medicare plan. That’s why MVP Medicare Advantage plans offer dental benefits to meet your needs.
All of our plans include coverage for preventive dental services. This includes up to two routine exams, cleanings, and sets of X-rays each year. Some plans cover additional comprehensive dental benefits, like fillings, root canals, crowns, and more. If your plan doesn’t include these additional benefits, you can add comprehensive dental coverage to take care of your smile with our Additional Dental Rider (see below).
Dental Benefit Highlights
All MVP Medicare Advantage plans cover two exams, two cleanings, and two sets of X-rays per calendar year.
You will receive a separate dental ID card for your dental plan. Show this card when you receive dental services. You can choose to go to any dentist, but your costs generally will be lower if you go to a DenteMax Medicare dentist.
Sign into your Member online account, and then click or tap My Benefits, then Member Guide (.PDF) to find your Evidence of Coverage for more information about benefit coverage and charges.
Generally, your costs will be lower if a DenteMax Medicare dentist treats you. 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 another dentist, you may pay more. Dentists outside of the DenteMax network can bill you for additional costs if what they charge is more than the maximum benefit amount for preventive services the plan covers.
Learn more about the DenteMax network and out-of-network dental fees:
- 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 a dentist 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, we may bill you for the difference.
You are responsible for:
- 100% of all charges that exceed the maximum allowable benefit amount
- Any services provided after you meet your annual allowance
- Any dental services this benefit doesn’t cover
- Costs for services once you reach your plan’s annual benefit amount
You can’t carry over any unused part of your annual benefit amount to the next calendar year. Sign into your Member online account to view 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.
Additional Dental Rider Coverage
The Additional Dental Rider gives you added benefits on top of your regular preventive dental care. These benefits include:
- Additional routine dental visits
- Oral surgery
- Root canals
- Periodontics (specialty dental care for gum disease and dental implants)
- Prosthetic devices, such as partial dentures and crowns
Please note: Our optional supplemental rider does not cover orthodontic care. See the table below for more on what we include in preventive dental and comprehensive dental coverage.
Preventive Dental Coverage
Preventive dental coverage is a part of all plans. Please see below for a list of what’s included with your preventive dental coverage.
|Two exams, two cleanings, and two sets of X-rays per year||Included with all plans|
Comprehensive Dental Coverage
We include comprehensive dental coverage with the following plans:
- MVP Medicare WellSelect Plus® with Part D
- MVP Medicare Preferred Gold® with Part D
- MVP Medicare Preferred Gold® without Part D
You can add comprehensive dental coverage to the following plans for an additional $25 per month Additional Dental Rider:
- MVP Medicare WellSelect® with Part D
- MVP Medicare Patriot Plan® with Part D
- MVP Medicare Secure® with Part D
- MVP Medicare Secure Plus® with Part D
Please see the table below for what’s included with our comprehensive dental coverage, as well as the associated costs.
|Plan Details||Cost (In-Network and Out-of-Network)|
|Annual maximum benefit||$1000|
|Additional exams, X-rays, simple extractions, fillings||20% of benefit allowed amount, after deductible|
|Oral surgery||20% of benefit allowed amount, after deductible|
|Endodontics (root canals)||50% of benefit allowed amount, after deductible|
|Periodontics||50% of benefit allowed amount, after deductible|
|Prosthodontics (partial dentures, crowns)||50% of benefit allowed amount, after deductible|
If you need to request a reimbursement for a dental service, download the Medical and Dental Claim Reimbursement Form (PDF).
Get the Dental Coverage You Need
If you’re shopping for a Medicare plan, find out how to enroll in an MVP Medicare Advantage plan. You can also call us at 1-800-368-4565 to speak with an MVP Medicare Advisor. You can enroll in both an MVP Medicare Advantage plan and the Additional Dental Rider at the same time.
If you’re a current MVP Medicare Advantage Plan member, call our Customer Care Center at 1-800-665-7924. You can add the optional rider to your current plan, or you can add it to a new MVP
Medicare Advantage Plan for the next calendar year. You can also choose “Enroll online” on our Enroll in a Medicare Advantage Plan page to add the optional rider coverage to your existing plan.
MVP Health Plan, Inc. is an HMO-POS/PPO/HMO D-SNP organization with a Medicare contract and a contract with the New York State Medicaid program. Enrollment in MVP Health Plan depends on contract renewal. MVP Health Plan, Inc. has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until 12/31/2024 based on review of MVP Health Plan’s Model of Care. Health benefit plans are issued by MVP Health Plan, Inc., an operating subsidiary of MVP Health Care, Inc. Not all plans available in all states and counties. Every year, Medicare evaluates plans based on a 5-star rating system. Out-of-network/non-contracted providers are under no obligation to treat MVP Health Plan members, except in emergency situations. 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. For accommodations of persons with special needs at meetings, call 1-800-324-3899 (TTY 711).
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Y0051_8263_M | Last Updated: 4/13/2023
Speak to a Representative
To shop for a plan, contact an MVP Medicare Advisor at 1-800-324-3899 (TTY 711)
For questions about your plan, contact the MVP Medicare Customer Care Center at 1-800-665-7924 (TTY 711).
If you have an MVP DualAccess plan, call 1-866-954-1872 (TTY 711).
From April 1-September 30, reach us Monday-Friday, 8 am-8 pm.
From October 1-March 31, reach us seven days a week, 8 am-8 pm.