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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
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
Comprehensive Services
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.

Always at Your Service

Please Contact a Health Plan Specialist
at 713-442-5646 (TTY: 711)

8 a.m.– 8 p.m. | 7 days a week | From October 1 to March 31

8 a.m.– 8 p.m. | Monday – Friday | From April 1 to September 30

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