Medicare Advantage dental plans
Many of our Medicare Advantage Prescription Drug plans now include coverage for dental that is not covered in your Medicare plan. Plus, you can add even more dental coverage to what is already included. Call today to learn more (800) 260-9607.
Medicare Advantage Prescription Drug Plans with dental coverage
With a Blue Shield Medicare Advantage Prescription Drug Plan, you may also get coverage for dental that is not covered in your Original 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 Medicare plans in your area
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2024 MAPD Plans with dental coverage by county
| County | Plan | 2024 Dental Highlights | Buy-up Options |
|---|---|---|---|
Blue Shield Inspire (HMO) |
Oral evaluations, X-rays, Cleanings |
Optional Supplemental Dental HMO |
|
Blue Shield Select (PPO) |
Oral evaluations, X-rays, Cleanings |
Optional Supplemental Dental PPO |
|
Kern |
Blue Shield 65 Plus (HMO) |
Not Covered |
Optional Supplemental Dental HMO Optional Supplemental Dental PPO |
Los Angeles |
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. $0 copay for oral evaluation and cleanings |
Optional Supplemental Dental HMO |
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 |
|
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. Benefit enhancements reducing copays to $0 copay for oral evaluation and cleanings |
Optional Supplemental Dental HMO |
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. Benefit enhancements reducing copays to $0 copay for oral evaluation and cleanings |
Optional Supplemental Dental HMO |
San Bernardino |
Blue Shield 65 Plus (HMO) Blue Shield 65 Plus Choice Plan (HMO) |
Oral evaluations, X-rays, Cleanings, Fillings, Crowns, Dentures, and more. Benefit enhancements reducing copays to $0 copay for oral evaluation and cleanings |
Optional Supplemental Dental HMO |
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. Benefit enhancements reducing copays to $0 copay for oral evaluation and cleanings |
Optional Supplemental Dental HMO |
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 |
Optional Supplemental Dental PPO |
|
Blue Shield TotalDual Plan (HMO D-SNP) |
Oral evaluations, Cleanings, Fillings, Crowns, Dentures, and more |
Not offered |
|
San Joaquin |
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 |
|
San Luis Obispo |
Blue Shield 65 Plus (HMO) |
Oral evaluations, X-rays, Cleanings |
Optional Supplemental Dental PPO |
San Mateo |
Blue Shield Inspire (HMO) |
Oral evaluations, X-rays, Cleanings |
Optional Supplemental Dental HMO |
Santa Barbara |
Blue Shield 65 Plus (HMO) |
Oral evaluations, X-rays, Cleanings |
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 |
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 or 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
When you choose the HMO plan buy-up, it includes:
- $15.00 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
With the Optional Supplement Dental HMO plan, benefits may include:
- 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
When you choose the PPO plan buy-up, it includes:
- $45.00 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
With the Optional Supplement Dental PPO plan, benefits may include:
- Choose from over 45,000 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
With a Blue Shield dental plan, you can get access to one of the largest dental networks statewide. It’s easy to find a dentist or see if your current dentist is in our network with our Find a Doctor tool.
Optional Supplemental Dental HMO plan vs Optional Supplemental Dental PPO plan
| Optional Supplemental Dental HMO | Optional Supplemental Dental PPO | |
|---|---|---|
$15.00 |
$45.00 |
|
Calendar-year deductible (not applicable to diagnostic and preventive services) |
None |
$50 |
Calendar-year maximum* |
None |
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. 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)
| 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% |
20% |
Diagnostic services: Comprehensive series of radiographic images (D0210) |
$0 copay |
0% |
20% |
Preventive care: Prophylaxis – adult (cleanings) (D1110) |
$5 copay |
0% |
20% |
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/$425 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.
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 and send it to the address provided on the enrollment form.
Optional Supplemental Dental HMO or PPO plan enrollment form - English (PDF, 94 KB)
Optional Supplemental Dental HMO or PPO plan enrollment form - Spanish (PDF, 73 KB)
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.
1 The Optional Supplemental Dental HMO plan is not available to Blue Shield Enhanced (HMO), Blue Shield AdvantageOptimum Plan (HMO), Blue Shield AdvantageOptimum Plan 1 (HMO), Blue Shield TotalDual Plan (HMO D-SNP), Blue Shield Inspire (HMO D-SNP), Blue Shield Select (PPO), and Blue Shield 65 Plus (HMO) members in the San Luis Obispo and Santa Barbara Counties. Refer to the plan Summary of Benefits for additional information.
2 The Optional Supplemental Dental PPO plan is not available to Blue Shield AdvantageOptimum Plan (HMO), Blue Shield AdvantageOptimum Plan 1 (HMO), Blue Shield TotalDual Plan (HMO D-SNP) and Blue Shield Inspire (HMO D-SNP) members. Refer to the plan Summary of Benefits for additional information.
3 Dental providers in California are available through a contracted dental plan administrator. Network numbers are as of June 2023.
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H2819_23_398A_M Accepted 09192023
Page last updated: 10/01/2023
