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Do Medicare Plans from Humana Cover Routine Dental?

November 03, 2017

If you’re currently enrolled in Original Medicare, you may be wondering if you’re covered for dental care. After all, your oral health is an important part of maintaining your overall health.

Unfortunately, with a few exceptions, you’re not covered for routine dental care if you have Original Medicare. However, some Medicare Advantage plans may offer additional coverage—including routine dental benefits. Medicare Advantage plans are available through Medicare-contracted private insurance companies like Humana.

Here is an overview of what Medicare covers when it comes to dental care and how you may be able to get dental coverage through a Medicare Advantage plan from Humana.

Does Medicare cover dental services?

As mentioned, except in a few special instances, Original Medicare doesn’t cover routine dental services, procedures, or related dental supplies. This includes:

  • Routine cleanings
  • Fillings
  • Extractions
  • Dental appliances (e.g., dentures, retainers, or dental plates)

In some cases, Medicare Part A may cover certain dental procedures if it’s related to a covered procedure you’re getting as an inpatient or if it’s an emergency dental procedure. For example, if you’re in the hospital for an oral surgery, Medicare may cover an oral exam as a medically necessary part of your pre-operation care, since the surgery itself is covered.

In general, if you have Original Medicare, you’ll have to pay for routine dental care out of pocket unless you have other coverage.

Does Humana offer dental insurance with its Medicare plans?

Although Original Medicare doesn’t cover most dental care, some Medicare Advantage plans, available through Humana, may include coverage for routine dental services like cleanings and annual x-rays. . Medicare Advantage (Part C) plans are another way to get the same Part A and Part B benefits you have under Original Medicare, except through a Medicare plan (such as an HMO plan or PPO plan*). In fact, Medicare-approved private insurance companies like Humana are required to offer at least the same level of coverage as Original Medicare (except for hospice, which is still covered through Part A). Many Medicare Advantage plans also may cover extra benefits beyond the federal program, such as prescription medications, hearing services, and routine dental care. Not every plan offers dental coverage, so make sure to check the specifics of the plan you’re considering if this is a benefit you’re interested in.

While there are some Humana Medicare Advantage plans that include routine dental coverage, there are also certain  Humana Medicare Advantage plans that have the option to add supplemental benefits for dental coverage and more. Benefits and costs vary depending on the specific plan, but may help with costs such as:

  • Routine cleanings and exams
  • Crowns
  • Fillings
  • Extractions
  • X-rays
  • Root canals

How do Humana’s Dental PPO and HMO plans work?

Currently, Humana offers certain Medicare Advantage plans with optional supplemental dental benefits, including:

  • MyOption Enhanced Dental HMO
  • MyOption Dental High PPO
  • My Option Enhanced Dental PPO

Humana’s dental coverage works differently depending on the type of Medicare Advantage plan you choose. For example, if you decide to enroll in a Medicare Advantage HMO plan from Humana, keep in mind you’re generally required to use in-network providers to be covered. If you go out of network for your dental care, you’re typically not covered and may have to pay the full cost for those services.

Humana’s dental PPO plans give you the option to use out-of-network providers for dental care, but your costs may be higher than if you stay in the plan’s network. It’s a good idea to read your Evidence of Coverage documents carefully to make sure you understand the plan’s rules and what your costs may be.

Please note that not all Medicare plans or coverage options by Humana are available in all locations, so always check your zip code to view plan options for your specific service area.

If you’d like help finding Medicare Advantage plans by Humana that cover dental care, just dial the phone number on this page for personalized assistance with a licensed insurance agent. Or, to get started right away, enter your zip code into the plan finder tool to browse plan options in your area.

*Out-of-network/non-contracted providers are under no obligation to treat Humana members, except in emergency situations. For a decision about whether we Humana l cover an out-of-network service, we encourage you or your provider to ask Humana for a pre-service organization determination before you receive the service. Please call Humana customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

Humana is a Medicare Advantage HMO, PPO and PFFS organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in any Humana plan depends on contract renewal.

You must continue to pay your Medicare Part B premium.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums, and/or member cost-share may change on January 1 of each year.

Humana MyOption optional supplemental benefits (OSB) are only available to members of certain Humana Medicare Advantage (MA) plans.  Members of Humana plans that offer OSBs may enroll in OSBs throughout the year. Benefits may change on January 1st each year.

Enrollees must continue to pay the Medicare Part B premium, their Humana plan premium, and the OSB premium.

Enrollees must use network providers for specific OSBs when stated in the Evidence of Coverage (EOC); otherwise, covered services may be received from non-network providers at a higher cost.

Last Updated: 11/3/2017

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