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Preventive Dental Coverage

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.

 

 

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