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Preventive Dental Benefits

Preventive Dental Benefits Summary

Your KelseyCare Advantage Plan includes a Preventive Dental benefit that is not covered by original Medicare. Services include routine preventive exams, cleanings and x-rays and is administered by FCL Dental.

Covered Preventive Dental Services

This chart shows a summary of your preventive dental benefits when you choose an in-network dentist. Any dental services provided by an out-of-network dentist are not covered.

Coverage Description
Copayment (Preventive services $25 per visit
Oral Exam 1 every 6 months
Cleaning 1 every 6 months
Bitewings (Two and Four) 1 every 12 months
Comprehensive Oral Exam 1 every 36 months
Intraoral - Complete Series 1 every 36 months

Search for an In-Network Dentist

Visit our partner site to search for a network dentist in your area. You can also call 1-866-535-8343 if you need help finding a participating dentist.

To access your preventive dental benefit you simply present your KelseyCare Advantage plan ID card to the FCL Dental provider you have chosen.

Always at Your Service

Call Member Services at at 713-442-CARE (2273) or toll-free at 1-800-535-8343 (TTY: 711) from 8 a.m. to 8 p.m., seven days a week, from October 1 to March 31 and 8 a.m. to 8 p.m., Monday through Friday, from April 1 to September 30.

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