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