Please Contact a Health Plan Specialist
at 713-442-5646 (TTY: 711)
2023 Preventive and Comprehensive Dental
Dental Benefits Summary
All KelseyCare Advantage Plans include preventive dental care coverage that Original Medicare does not cover. With routine preventive exams, cleanings, and X-rays, with services performed by FCL Dental, we help our members feel better about their dental health and keep them smiling. Members must use an in-network dentist when using all dental benefits. Any dental services provided by an out-of-network dentist will not be covered.
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 present your KelseyCare Advantage plan ID card to the FCL Dental provider you have chosen.
Preventive Dental Benefits Cost-Share
| Coverage Description | |
| Copayment | $0 per visit |
| Oral Exams | 1 every 12 months |
| Cleanings | 1 every 6 months |
| X-rays | 1 every 12 months* |
*Refer to the Evidence of Coverage for each plan for detailed dental benefit information, this is only a summary.
Comprehensive Dental Coverage
| Plan Name | Preventive Services Covered (Type I) |
Comprehensive Services Covered (Type II & III) |
Annual Maximum Benefit |
Type II & III Services Cost-Share |
| Platinum | Yes | Yes | $2,000 | 50% coinsurance |
| Gold Freedom | Yes | Yes | $2,000 | 50% coinsurance |
| Silver | Yes | Yes | $1,500 | 50% coinsurance |
| Silver Freedom | Yes | Yes | $1,500 | 50% coinsurance |
Preventive Dental Coverage Only
| Plan Name | Preventive Services Covered |
Comprehensive Services Covered |
Optional Supplemental Dental Buy-Up Plan |
Optional Supplemental Dental Annual Maximum Benefit (if purchased) |
| Gold | Yes | No | Available for $32.80 per month | $3,000 |
| Gold Community | Yes | No | Available for $32.80 per month | $3,000 |
| Silver Community | Yes | No | Available for $32.80 per month | $3,000 |
If you are interested in adding supplemental dental coverage, please visit our Supplemental Dental Insurance page.