Do Medicare Plans from Humana Cover Routine Dental?

Humana is a private insurance company contracted with the Medicare program to provide Medicare Advantage plans and stand-alone Medicare Part D Prescription Drug Plans. Depending on plan availability and which Medicare Advantage plan you have from Humana, you may be able to add a Humana MyOptionSM dental plan to your Humana plan, to get routine dental benefits and more.

Does Medicare cover dental care?

Original Medicare (Part A and Part B) doesn’t cover most dental care, procedures, or supplies, such as cleanings, fillings, tooth extractions, dentures, or other dental devices. Medicare Part A (hospital insurance) pays for certain services that you get as an inpatient, like those related to serious injuries or medical conditions that involve the teeth or jaws. For example, Medicare may cover care related to treatment for oral cancers, or a fracture in the jaw related to a fall.

Do Medicare Advantage plans from Humana cover routine dental care?

Medicare Advantage plans (such as those available from Humana) offer an alternative way to get your health benefits under Original Medicare. By law, all of Humana’s Medicare Advantage plans must cover the same benefits as Original Medicare, except for hospice care, which is still covered under Part A. Medicare Advantage plans usually include Medicare Part D coverage of prescription drugs as well. Some Humana Medicare Advantage plans include coverage for routine dental services like cleanings and annual x-rays.

You may also be eligible to enroll in a Humana MyOptionSM plan to add onto your Humana Medicare Advantage plan benefits.

There are several different Humana MyOptionSM dental plans. These optional supplemental benefits offer varying levels of coverage and coverage limits for most routine dental services, such as:

  • Up to two routine dental exam visits per year; you may be eligible for 100% coverage of these services.
  • One set of bite-wing x-rays per year; some plans may offer 100% coverage for this service.
  • Up to two routine dental cleanings per year; some Humana MyOptionSM dental plans may cover this at no cost to you.
  • Help paying for basic dental care services such as fillings and crowns.
  • Partial coverage for major dental services such as extractions, root canals, periodontal scaling, and dentures and denture adjustments.

Please note that Humana MyOptionSM dental plan coverage may have annual deductibles, copayments or coinsurance amounts, and annual caps on dental benefits. Some plans may also have different benefit levels depending on whether you get your routine dental care from providers within the plan’s network or get treatment out of network (e.g., if you enroll in a Humana MyOptionSM Enhanced Dental PPO* plan).

How do I add dental coverage to my Humana Medicare Advantage plan?

You can sign up for a MyOptionSM dental plan at any time of year, even though you can only enroll in Medicare Advantage plans during certain periods. However, not every MyOptionSM dental plan can be added to every Humana Medicare Advantage plan, so you may want to contact your plan and ask.

If you are enrolled in Original Medicare or another Medicare Advantage plan that’s not from Humana, you may have to wait until the Annual Election Period (Fall Open Enrollment) to switch to a Humana Medicare Advantage plan. Remember, any Medicare Advantage plan option, including a Medicare Advantage plan from Humana, is an alternative method of getting your Original Medicare (Part A and Part B) coverage; routine dental care is a supplemental option with some of Humana’s Medicare Advantage plans.

Keep in mind that Humana is a private company contracted with Medicare and not all plans may be available in all areas. In addition, your plan premiums and benefits may vary depending on the plan you choose and where you live. If you enroll in any Medicare Advantage plan, you must continue to pay your monthly Medicare Part B premium plus any additional premiums required by your plan, including, in some cases, a separate premium for your Humana MyOptionSM dental plan; copayments and deductibles may also apply. If you’d prefer, we can help you find and choose a Medicare Advantage plan option to suit your needs. Just call one of our licensed insurance agents at the number on this page.

*Out-of-network/non-contracted providers are under no obligation to treat Humana members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. 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.

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 Medicare plan depends on contract renewal.

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.

You must continue to pay your Medicare Part B premium.

The [Formulary, pharmacy network, and/or provider network] may change at any time. You will receive notice when necessary.

Humana’s pharmacy network offers limited access to pharmacies with preferred cost sharing in urban areas of < AL, CA, CT, DC, DE, IA, IL, IN, KY, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NH, NJ, NY, OH, OR, PA, RI, SC, SD, TN, VA, VT, WA, WI, WV; suburban areas of AZ, CA, CT, DE, HI, IL, MA, MD, ME, MI, MN, MO, MT, ND, NH, NJ, NY, OH, OR, PA, PR, RI, VT, WA, WV >; and rural areas of < AK, IA, MN, MT, ND, NE, SD, VT, WY > . There are an extremely limited number of preferred cost share pharmacies in urban areas in the following states: < DE, MA, MD, ME, MI, MN, MS, ND, NY, OH, SC, and VT> ; suburban areas of: < MT and ND > ; and rural areas of: < ND >. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including pharmacies with preferred cost sharing, please call Customer Care at <1-800-281-6918 (TTY: 711)> or consult the online pharmacy directory at Humana.com.

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.

This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.

Last Updated Date: 7/30/2017


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