Dental Coverage

Dental Coverage for New York Residents

Dental Coverage for New York Residents
As Medicare Parts A and B do not include routine dental services, my clients have asked for some recommendations on plans available in New York.  As I receive many calls on this topic, I started looking for an individual plan based on my Schenectady County, New York address I have learned there are three approaches to obtaining individual dental coverage, with options to consider within each.

I) Dental Insurance Plans

All dental insurance plans include a monthly premium. Some policies require a waiting period or deductible amount to be paid before benefits begin. Some may also have an annual or lifetime cap on claims. After doing some research, including feedback from clients and area dentists, I have come across three insurance plans most frequently recommended:

  1. Physicians Mutual. I have scanned and included below information I received by mail from this company. What I like about their policies is No Deductible, No Annual Benefit Cap and you can receive an exact quote of how much of your claim will be paid before having the dental work done.  VISIT SITE
  2. Cigna. This company offers three stand alone plans; preventative with no deductible or waiting period and two traditional plans with deductible and annual maximum. What I like most about Cigna is the positive feedback from area dentists participating in the Cigna network. OBTAIN A CIGNA QUOTE HERE
  3. AARP Delta Dental. Many of my Medicare Supplement clients belong to AARP who has partnered with Delta Dental in offering two PPO plans (visit any dentist) and one prepaid dental HMO plan. Both PPO plans include a deductible and annual maximum. What I like about this offer is simple: both AARP and Delta Dental are trusted brands.  VISIT SITE 

II) Dental Savings Plans

Much like membership in AAA, AARP or other associations representing a large group of buyers, joining a Dental Savings Plan can reduce the your cash price for preventative and comprehensive dental services at offices offering the group discount.

  1. VitalSavings by Aetna Present your dental savings card at participating dentists in the US and save 15-50%
  2. Ameriplan $24.95 to $39.95 monthly offers similar savings at dentists nationwide. Call 1-800-647-8421

III) Dental Riders added to a Medicare Advantage Plan

Medicare Advantage plans are designed to provide medical and prescription drug coverage foremost. Some may include an additional benefit such as preventative dental such as one or two cleanings per year.  Other Medicare Advantage plans offer an optional add-on Dental Rider which provides coverage beyond the preventative / cleanings. For example, in the New York Capital Region I am familiar with the add-on rider available through these Medicare Advantage companies. It is my observation that Medicare Advantage carriers are not as focused on dental coverage as Dental Insurance carriers. For that reason, adding a rider to your Medicare Advantage plan, while attractively priced, is my third (not first) recommendation.

Company MA Plan MA Prem + Dental  Comments
United Healthcare
R5342-001
$17
 $39
$100 deductible
20-50% co-insurance
$1000 maximum benefit
Download Information (PDF)
United Healthcare
R5342-005
$47
 $30
$100 deductible 
20-50% co-insurance 
$1000 maximum benefit
Download Information (PDF)
Aetna
H5521-112
$51
$21
$50 deductible
50-55% co-insurance
$1000 maximum benefit
Review page 221 (PDF)

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