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Supplemental Dental Benefits
Comprehensive dental benefits are available through an optional supplemental dental plan for members enrolled in our Gold, Gold Community, and Silver Community plans. These supplemental benefits are not covered by Original Medicare. Members of qualifying plans must enroll separately into the supplemental dental plan and agree to pay a separate premium.
The supplemental dental plan is administered by FCL Dental.
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.
Once you are enrolled, you can access services from your supplemental dental plan. Simply present your KelseyCare Advantage plan ID card to the FCL Dental provider you have selected.
Covered Dental Services
While preventive dental benefits are included in your KelseyCare Advantage plan, the supplemental dental plan is an optional comprehensive plan that covers additional dental services such as fillings, extractions, crowns, root canals, and dentures.
|Monthly Premium Amount||$32.80|
|Copayment (Type I - Preventive Services)||
$25 per visit in 2022
$0 per visit in 2023
|Annual Maximum (After the annual maximum is exhausted, any remaining charges are your responsibility)||$3,000|
Percentage of Covered Dental Expenses Payable
Once the deductible is met, Type II (basic services) and Type III (major services) will be covered at the below coinsurance percentage rates and paid by FCL Dental, up to the Annual Maximum.
|Service Type||Service Description||Coverage Rate||Amount You Pay|
|Type II||Basic Services||80%||20% of the cost|
|Type III||Major Services||50%||50% of the cost|
Preventive dental services are covered by your KelseyCare Advantage medical plan and, therefore, are not included in the supplemental dental plan.
Need an ID Card?
If you’re a KelseyCare Advantage plan member and are currently enrolled in supplemental dental coverage, you can print instructions on how to access care here.
Alternatively, you can show the dental office your KelseyCare Advantage Medical ID and they can contact our Member Services department to confirm your benefits.