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.