2023 Medicare Advantage Prescription Drug (MAPD) Plans with Dental Coverage

Here's some good news: Many of our MAPD plans now include coverage for dental that is not covered in your Medicare plan. The additional coverage is provided at no extra premium cost to you. This includes coverage for dental services such as routine oral evaluations, cleanings, X-rays, fillings, crowns, dentures, and more. Plus, you can add even more dental coverage to what is already included.

Explore MAPD plans with dental coverage in your area for full plan details.

2023 MAPD Plans with Dental Coverage by County

COUNTY PLAN 2023 DENTAL HIGHLIGHTS BUY-UP OPTIONS
Alameda Blue Shield Inspire (HMO) Oral evaluations, X-rays, Cleanings Optional Supplemental Dental HMO
Optional Supplemental Dental PPO
Blue Shield Select (PPO) NEW: Oral evaluations, X-rays, Cleanings Optional Supplemental Dental PPO
Fresno Blue Shield Inspire (HMO D-SNP) Oral evaluations, Cleanings, Fillings, Crowns, Dentures, and more Not offered
Los Angeles Blue Shield 65 Plus (HMO), Blue Shield 65 Plus Plan 2 (HMO), Blue Shield Balance (HMO), Blue Shield Inspire (HMO) Oral evaluations, X-rays, Cleanings, Fillings, Crowns, Dentures, and more
NEW: $0 copay for oral evaluation and cleanings.
Optional Supplemental Dental HMO
Optional Supplemental Dental PPO
Blue Shield AdvantageOptimum Plan (HMO) Oral evaluations, X-rays, Cleanings, Fillings, Crowns, Dentures, and more Not offered
Blue Shield TotalDual Plan (HMO D-SNP) Oral evaluations, Cleanings, Fillings, Crowns, Dentures, and more Not offered
Blue Shield Enhanced (HMO) Oral evaluations, X-rays, Cleanings, Fillings, Crowns, Dentures, and more Optional Supplemental Dental PPO
Merced Blue Shield Inspire (HMO D-SNP) Oral evaluations, Cleanings, Fillings, Crowns, Dentures, and more Not offered
Blue Shield Inspire (HMO) Oral evaluations, X-rays, Cleanings Optional Supplemental Dental HMO
Optional Supplemental Dental PPO
Orange Blue Shield 65 Plus (HMO), Blue Shield 65 Plus Plan 2 (HMO), Blue Shield Inspire (HMO) Oral evaluations, X-rays, Cleanings, Fillings, Crowns, Dentures, and more
NEW: benefit enhancements reducing copays to $0 copay for oral evaluation and cleanings
Optional Supplemental Dental HMO
Optional Supplemental Dental PPO
Blue Shield AdvantageOptimum Plan (HMO) Oral evaluations, X-rays, Cleanings, Fillings, Crowns, Dentures, and more Not offered
Blue Shield Enhanced (HMO) Oral evaluations, X-rays, Cleanings, Fillings, Crowns, Dentures, and more Optional Supplemental Dental PPO
Blue Shield Select (PPO) Oral evaluations, X-rays, Cleanings Optional Supplemental Dental PPO
Blue Shield TotalDual Plan (HMO D-SNP) Oral evaluations, X-rays, Cleanings, Fillings, Crowns, Dentures, and more Not offered
Riverside Blue Shield 65 Plus Choice Plan (HMO) Oral evaluations, X-rays, Cleanings, Fillings, Crowns, Dentures, and more
NEW: benefit enhancements reducing copays to $0 copay for oral evaluation and cleanings
Optional Supplemental Dental HMO
Optional Supplemental Dental PPO
Sacramento Blue Shield Inspire (HMO) Oral evaluations, X-rays, Cleanings, Fillings, Crowns, Dentures, and more Optional Supplemental Dental PPO
San Bernardino Blue Shield 65 Plus (HMO), Blue Shield 65 Plus Choice Plan (HMO) Oral evaluations, X-rays, Cleanings, Fillings, Crowns, Dentures, and more
NEW: benefit enhancements reducing copays to $0 copay for oral evaluation and cleanings
Optional Supplemental Dental HMO
Optional Supplemental Dental PPO
Blue Shield TotalDual Plan
(HMO D-SNP)
Oral evaluations, X-rays, Cleanings, Fillings, Crowns, Dentures, and more Not offered
San Diego Blue Shield 65 Plus (HMO) Oral evaluations, X-rays, Cleanings, Fillings, Crowns, Dentures, and more
NEW: benefit enhancements reducing copays to $0 copay for oral evaluation and cleanings
Optional Supplemental Dental HMO
Optional Supplemental Dental PPO
Blue Shield AdvantageOptimum Plan 1 (HMO) Oral evaluations, X-rays, Cleanings, Fillings, Crowns, Dentures, and more Not offered
Blue Shield Select (PPO) Oral evaluations, X-rays, Cleanings, Fillings, Crowns, Dentures, and more
NEW: benefit enhancements reducing copays to $0 copay for oral evaluation and cleanings
Optional Supplemental Dental PPO
Blue Shield TotalDual Plan (HMO D-SNP) Oral evaluations, Cleanings, Fillings, Crowns, Dentures, and more Not offered
San Joaquín Blue Shield Inspire (HMO D-SNP) Oral evaluations, Cleanings, Fillings, Crowns, Dentures, and more Not offered
Blue Shield Inspire (HMO) Oral evaluations, X-rays, Cleanings Optional Supplemental Dental HMO
Optional Supplemental Dental PPO
San Luis Obispo Blue Shield 65 Plus (HMO) NEW: Oral evaluations, X-rays, Cleanings Optional Supplemental Dental PPO
San Mateo Blue Shield Inspire (HMO) Oral evaluations, X-rays, Cleanings Optional Supplemental Dental HMO
Optional Supplemental Dental PPO
Santa Barbara Blue Shield 65 Plus (HMO) NEW: Oral evaluations, X-rays, Cleanings Optional Supplemental Dental PPO
Santa Clara Blue Shield Inspire (HMO) Oral evaluations, X-rays, Cleanings Optional Supplemental Dental HMO
Optional Supplemental Dental PPO
Stanislaus Blue Shield Inspire (HMO D-SNP) Oral evaluations, Cleanings, Fillings, Crowns, Dentures, and more Not offered
Blue Shield Inspire (HMO) Oral evaluations, X-rays, Cleanings Optional Supplemental Dental HMO
Optional Supplemental Dental PPO

Blue Shield 65 Plus is a service mark of Blue Shield of California.

Optional Supplemental Dental plans for MAPD

Blue Shield of California offers two supplemental dental plans that can enhance the dental coverage in the plans above. Depending on the MAPD plan you enroll in, you may choose between an Optional Supplemental Dental HMO1 plan and an Optional Supplemental Dental PPO2 plan. These plans offer a wide range of dental benefits, including many diagnostic and preventive services, at no charge to you.

HMO plan buy-up

  • $12.50 monthly plan premium
  • Choose a participating dentist from our large network
  • No deductibles
  • No waiting period

Why enroll in the Optional Supplemental Dental HMO plan:

  • Many annual routine and diagnostic care services, such as teeth cleaning and X-rays, are available at a low cost, or no cost, to you
  • No deductibles or annual benefit limits
  • Fixed copayments for basic and major services
  • Specialty care provider services available with a referral from your primary dental provider3
  • No waiting period and no claim forms

PPO plan buy-up

  • $42.30 additional monthly plan premium
  • See any dentist; you will generally pay less for services when you see a participating dentist
  • $50 calendar-year deductible for services beyond diagnostic and preventative services
  • No waiting period

Why enroll in an Optional Supplemental Dental PPO plan​:

  • Choose from over 44,000 general and specialist dentists for maximum coverage. If your dentist is not in our network, you can keep seeing him/her or other non-network dentists, and still get coverage3
  • Specialist care available with no referral needed from your dentist3
  • A wide range of dental benefits, including 100% coverage for diagnostic and preventive services obtained from a participating dentist
  • No waiting periods
  • No claim forms if you go to a network dentist

 

Find a dentist

It’s easy to find a dentist or see if your current dentist is in our network. Use our Find a Doctor tool, and select “Dentists” to explore plans and find a dentist in your area.
Find a dentist

Optional Supplemental Dental HMO plan vs Optional Supplemental Dental PPO plan​

  Optional Supplemental Dental HMO Optional Supplemental Dental PPO
Monthly Optional Supplemental Dental plan premium $12.50 $42.30
Calendar-year deductible (not applicable to diagnostic and preventive services) None $50
Calendar-year maximum* $1,000 for covered endodontic, periodontic and oral surgery services when performed by an in-network dental specialist. The maximum amount the plan will pay for covered services and supplies is $1,500 in a calendar year. Up to $1,000 of this maximum amount may be used for covered services and supplies received from non-participating dentists in a calendar year. You pay any amount above the $1,500 benefit maximum in a calendar year.
Waiting period for major services None None
Network access Participating dentists only Participating dentists and non-participating dentists

*All services must be performed, prescribed, or authorized by a participating dentist. If you need to see a specialist and you are enrolled in the Optional Supplemental Dental HMO plan, you must get a referral from your primary dentist to receive covered specialist services. Plan pays a maximum of $1,000 per calendar year for covered specialist services. You are responsible for amounts above $1,000. If you are enrolled in the Optional Supplemental Dental PPO plan, you may go directly to a specialist.

 

Summary list of services covered with your cost share (amount you pay) 

Service Area Code1 You pay with dental HMO plan You pay with dental PPO plan
  Participating providers Participating providers Non-participating providers
Diagnostic services: Comprehensive oral evaluation (D0150) $5 copay 0%
(1 visit in 6 months)
20%
(1 visit in 6 months)
Diagnostic services: Full mouth X-rays (D0210) $0 copay
(1 series every 24 months)
0%
(1 series every 24 months)
20%
(1 series every 24 months)
Preventive care: Prophylaxis – adult (cleanings) (D1110) $5 copay 0%
(1 cleaning every 6 months)
20%
(1 cleaning every 6 months)
Restorative services: One surface composite resin restoration – anterior (D2330) $11 copay 20% 30%
Restorative services: Crown (porcelain fused to noble metal) (D2750) $275 copay 50%
(1 per plan year every 5 years)
50%
(1 per plan year every 5 years)
Endodontics: Anterior root canal therapy (D3310) $195/$268 copay 1 per lifetime
(exact tooth)
50% 50%
Endodontics: Molar root canal therapy (D3330) $335/$42 copay
(1 per lifetime)
50% 50%
Periodontics: Osseous surgery/four or more teeth per quadrant (D4260) $293 copay
(1 every 36 months)
50%
(1 every 36 months)
50%
(1 every 36 months)
Periodontics: Periodontal scaling & root planing/four or more teeth per quadrant (D4341) $45 copay
(1 every 12 months)
50%
(1 every 24 months)
50%
(1 every 24 months)
Prosthetics: Complete denture (upper or lower) (D5110 or D5120) $285 copay
(1 per plan year every 5 years)
50%
(1 every 60 months)
50%
(1 every 60 months)
Prosthetics: Bridge retainer – crown porcelain fused to high noble metal (per unit) (D6750) $275 copay
(1 per plan year every 5 years)
50%
(1 every 60 months)
50%
(1 every 60 months)
Oral surgery: Extraction (single erupted tooth) (D7111) $10 copay
(1 per lifetime)
50%
(2 per lifetime)
50%
(2 per lifetime)
Oral surgery: Removal of impacted tooth (complete bony) (D7240) $80 copay
(1 per lifetime)
50%
(2 per lifetime)
50%
(2 per lifetime)

ADA codes are procedure codes established by the American Dental Association for efficient processing and reporting of dental claims.
You pay the copayment plus the cost of precious or semi-precious metals. Porcelain on molar crowns is not a covered benefit.
For the Optional Supplemental Dental HMO plan, your copayment will be higher if services are performed by a specialist.

 

Enroll in optional dental coverage 

Current Medicare Advantage-Prescription Drug Plan members can sign up using the Optional Supplemental Dental HMO or PPO plan enrollment form (PDF, 193 KB) and send it to us at the address provided on the enrollment form.

If you have any questions about applying for dental coverage, you can call (877) 890-7587 (TTY: 711) to speak with a Blue Shield of California Medicare adviser. Hours of operation are 8 a.m. to 8 p.m. seven days a week, from October 1 through March 31, and 8 a.m. to 8 p.m., weekdays from April 1 through September 30.