What to know about Tufts Medicare plans and dental coverage
Massachusetts-based Tufts Health Plan offers Medicare Advantage plans with dental coverage. In some cases, dental care is available as an add-on option.
Tufts Health Plan is a nonprofit insurer. The company provides Medicare plans — including Medicare Advantage Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans — for people in Massachusetts, New Hampshire, and Rhode Island.
Read on to learn more about Tufts Health Plan and what Medicare Advantage dental coverage they offer.
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
What dental coverage do Tufts Medicare plans offer?
Tufts Health Plan offers dental coverage with their Medicare Advantage HMO Dental Option plan and their Medicare Supplement Dental Option plan.
A plan may already include dental coverage, or this benefit may be available as an add-on service. Dominion National administers the dental benefits.
Learn more about Tufts Medicare Advantage plans.
HMO Preferred Dental Option
The HMO Preferred Dental Option plan offers help with the following costs:
preventive services, such as oral exams and routine cleanings
restorative services, including fillings and simple extractions
major restorative services, such as crowns, dentures, and root canals
Learn more about Medicare HMO plans.
PPO Preferred Access Plan
The PPO Preferred Access Plan includes the Flex Advantage spending card, which is a prepaid Visa card that can provide coverage for dental services up to $1,500 per year in 2025, including:
cleanings
composite fillings
crowns
dentures
fillings
implants
root planing
scaling
simple extractions
The Flex Advantage Visa card also includes an allowance of $130 per calendar quarter to spend on over-the-counter medications and health items that have Medicare approval. This could include:
toothpaste
toothbrushes
dental floss and floss picks
denture cream
pain relief gel for toothaches
Learn more about Medicare PPO plans.
Medicare Supplement Dental Option
A person enrolling in the company’s Medicare Supplement Dental Option plan can visit any licensed dentist, regardless of whether they are in-network.
The plan may offer several benefits, including:
oral exams and cleaning
simple extractions and fillings
crowns
bridges
dentures
Learn more about Medicare coverage for dental treatments.
Costs of Tufts Medicare plans
Costs for Tufts Medicare plans offering dental coverage will vary depending on factors such as where the individual lives and the benefits the plan offers.
Some plans may not cover certain services. If a plan does not automatically include dental benefits, a person must actively add the benefit to their policy. Therefore, the monthly premium costs more than for the plans with integrated dental coverage.
Learn more about Medicare Advantage costs.
Eligibility for Tufts Medicare plans
Tufts Health Plan offers plans that are available to those who qualify for Medicare and live in the plan’s coverage area. It covers Massachusetts, New Hampshire, and Rhode Island.
A person age 65 years or older can qualify for Medicare based on their age. Younger people may also qualify for Medicare if they have certain conditions, including end stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS).
A person can check for available plans using the Medicare online tool or by searching by ZIP code on the Tufts Health Plan website.
Learn more about Medicare Advantage eligibility.
Rules and exclusions
Tufts Health Plan does not have a specific period during which a person can add a dental option to their plan. If a person is already enrolled in a Tufts Health Plan, they can contact their plan administrator and ask to add the dental option to their plan.
Tufts Health Plan provides the dental option as a PPO plan. With a PPO, a person will generally get the most significant cost savings when they choose in-network providers.
Summary
Tufts Health Plan offers dental services as either an incorporated or add-on benefit of their Medicare plans. This includes HMO and PPO plans.
A person can also get a supplemental dental policy if they have Original Medicare and live in Massachusetts, New Hampshire, and Rhode Island.
View the original article on Medical News Today
