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Supplemental Dental Option

Supplemental Comprehensive Dental Coverage

Benefits Summary

Comprehensive dental benefits are available through an optional supplemental dental plan for members enrolled in our Classic plan. 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.

Coverage Description
Monthly Premium Amount $32.80
Annual Deductible $25
 Copayment (Type I - Preventive Services) $0 per visit 
 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.

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Need Answers?

Call our Concierge team at 713-442-CARE (2273) or toll-free at 1-866-535-8343 (TTY: 711)

From October 1 to March 31

8 a.m. - 8 p.m.

7 days a week

From April 1 to September 30

8 a.m. - 8 p.m.

Monday - Friday

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