Does Wellcare Cover Dental Implants?

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A dental implant is a metal post that is surgically implanted into the gum to take the place of a tooth’s root. An artificial tooth is then secured to the post. 

Dental implants are among the most complex and costly dental procedures, so it stands to reason why Wellcare beneficiaries in need of a dental implant may be wondering if the procedure is covered. 

While many Wellcare Medicare Advantage plans may offer dental benefits, not all of these plans will cover dental implants. If you have a Wellcare Medicare plan, check with your plan carrier directly to find out if your plan covers dental implants. If not, you may need to pay for some or all of the costs of your dental implants out of your own pocket.

When Do Wellcare Medicare Advantage Plans Pay for Dental Care?

Wellcare sells Medicare Advantage (Medicare Part C) plans, many of which may include dental coverage.

Medicare Advantage plans like the ones offered by Wellcare provide all of the same benefits as Original Medicare (Medicare Part A and Part B), and most plans offer additional coverage for things Original Medicare doesn’t cover. These additional benefits may include things like dental, vision, hearing, prescription drugs and more. 

While Wellcare Medicare Advantage plans that include dental benefits may cover a range of covered dental services, they do not typically cover dental implants. 

Some of the covered dental benefits you might find in a Wellcare Medicare Advantage plan may include some of the following dental care items and services.

Preventive care 

Routine dental coverage typically includes things like exams, X-rays, teeth cleanings and fluoride treatments.

Emergency care

Many plans may also cover emergency dental care required to save a tooth, stop ongoing tissue bleeding, alleviate severe pain or reconstruction of the mouth and jaw following an injury. 

Comprehensive care

More advanced dental services that may be covered by a Wellcare Medicare Advantage plan may include fillings, extractions, root canals, dentures, deep cleanings and various surgical procedures. 

How Does Medicare Advantage Dental Coverage Work?

Medicare Advantage dental coverage is not unlike other types of dental insurance. You may have a monthly premium in order to belong to the plan, although many Medicare Advantage plans offer low premiums. 

There may or may not be an annual deductible as part of the plan, which is the amount of money you’ll have to spend on covered care before the plan begins to offer coverage. Once the deductible is reached, you’ll typically be responsible for copayments or coinsurance for covered care, which is your share of the billed cost. 

You will likely need to see a provider who is a participating member of the plan’s network. If not, you may be responsible for a higher share of the cost or even the full amount. 

How Can You Get Coverage of Dental Implants?

There are thousands of Medicare Advantage plans offered across the U.S. by dozens of different insurance companies. And some of these plans may cover dental implants.

Contact a licensed insurance agent to find a Medicare Advantage plan available where you live that includes coverage of dental implants. It can be especially helpful to work with an agent who is licensed to sell plans on behalf of multiple different carriers, as that may allow you to cast the widest net in your search for dental implant coverage. 

If you are outside of your Initial Enrollment Period (IEP), you may have to wait until the Annual Enrollment Period (AEP) that takes place from Oct. 15 to Dec. 7 each year. This is the time when many Medicare beneficiaries may enroll in, drop or switch Medicare Advantage plans and would be your opportunity to enroll in a plan with dental implant coverage.