Optional Supplemental Comprehensive Dental Benefit

 

Dental care is an important part of your overall health. In addition to maintaining the health of your mouth through your preventive dental visits, Independent Health is excited to offer comprehensive dental coverage on some of our Medicare Advantage plans.

Here is how the Optional Supplemental Comprehensive Dental Benefit works:

  • You pay a $25 monthly premium in addition to your monthly plan premium.
  • No annual deductible.
  • You pay 50% coinsurance.
  • Includes a maximum annual allowance of $3,000.
    • On the first of each quarter (January 1, April 1, July 1 and October 1) you earn $750 of the comprehensive dental benefit.
    • Unused balances will carry over from quarter to quarter.
    • Coverage is based on the available balance on date of service.
    • Any unused balance will expire on December 31.

The services that are available to you with this benefit include restorative, endodontics, periodontics and more. You must use a Healthplex dental provider to get the services covered with this benefit. For a list of Healthplex dental providers, visit the Find a Medicare Provider section.

Covered services to help you get and stay healthy:

  • Crowns
  • Denture, complete or partial
  • Denture repairs
  • Endodontic therapy
  • Fillings
  • Non-surgical root canal obstruction treatment
  • Periodontal cleanings
  • Retreatment of previous root canal therapy
  • Root repairs
  • Scaling
  • Tooth extractions
  • Tooth fractures and repairs
  • And more

For a complete list of services see our Evidence of Coverage.


The following Medicare Advantage Plans are eligible for this benefit:

  • Independent Health’s Encompass 65® Element HMO
  • Independent Health’s Encompass 65® Basic HMO
  • Independent Health’s Medicare Passport® Advantage PPO
  • Independent Health’s Encompass 65® Core HMO
  • Independent Health’s Assure Advantage® HMO C-SNP

Please note: If you join Independent Health’s Medicare Passport® Prime (PPO) or Encompass 65® HMO (without prescription coverage) the Optional Supplemental Comprehensive Dental Benefit is built into your plan and includes:

  • No additional premium.
  • Access to the entire $3,000 on the first
  • Coverage up to $3,000 (annual max.).
  • No annual deductible. day your membership is effective.
  • Member cost share of 50% coinsurance will apply.

How and when you can enroll:

  • You can enroll in this benefit during the annual enrollment period (AEP), which begins on October 15 and ends on December 7. Your dental coverage will be effective January 1.
    • Current and new Medicare Advantage members who want to elect this benefit for the first time need to complete an Optional Supplemental Dental Benefit enrollment form no later than December 31. Coverage would begin January 1.
    • If you choose not to select dental coverage during AEP, you have 30 days from January 1 to enroll in this benefit.
    • If you are a current Medicare member and have previously elected the optional supplemental dental benefit your coverage will continue if your plan membership does not change.
  • If you’re new to Medicare, you can enroll in one of our eligible Medicare Advantage plans during your initial coverage election period (ICEP). Your dental coverage and your Medicare Advantage plan coverage will be effective on the same day.
    • If you didn’t select this coverage during your ICEP, you can choose to enroll in the benefit during the first 30 days of your enrollment in your plan. The Optional Supplemental Dental benefit will be effective on the first day of the following month.
    • Complete the Optional Supplemental Dental Benefit enrollment form and return it to Independent Health.
  • If you have a special election period (SEP), you have 30 days from your Independent Health Medicare plan’s start date to elect dental coverage.
    • Complete the Optional Supplemental Dental Benefit enrollment form and return it to Independent Health.
  • For assistance enrolling, speak with a RedShirt at (716) 635-4900 or 1-800-958-4405 (TTY: 711)
    October 1 – December 7: Monday – Sunday, 8 a.m. – 8 p.m.
    December 8 – September 30: Monday – Friday, 8 a.m. – 8 p.m.
    medicarehelp@independenthealth.com