Medicare News
Published May 28, 2019
Many of our Premera Medicare Advantage plans include preventive dental coverage, offering members access to hundreds of local dentists in our Medicare Advantage dental network.
How you can help
We know you want to help your clients get the oral care they need because healthy oral habits are linked to overall health. Use the information below to explain Premera Medicare Advantage dental benefits to your clients.
Plans at a glance
This chart shows what plans include embedded dental benefits and those that can be paired with an optional dental rider.
| Plan |
Embedded Dental |
Optional Rider |
| HMO |
No |
Yes |
| Classic HMO |
Yes |
N/A |
| Classic Plus HMO |
Yes |
N/A |
| Total Health HMO |
Yes |
N/A |
| Core HMO |
No |
Yes |
| Peak + Rx (HMO) |
No |
No |
| Sound + Rx (HMO) |
Yes |
N/A |
| Alpine (HMO) |
No |
No |
| Charter + Rx (HMO) |
Yes |
N/A |
Embedded dental benefits
Here’s an overview of benefits offered in our embedded dental plans.
Classic HMO, Classic Plus HMO, and Total Health HMO
| Benefits |
Allowance |
| Routine oral exams |
$0 copay (2 every year) |
| Limited problem-focused (emergency) exam |
$0 copay (1 every year) |
| Palliative (emergency) treatment of dental pain |
$0 copay |
| Cleanings and periodontal maintenance |
$0 copay (2 every year, in any combination) |
| Fluoride treatments |
$0 copay (1 every year) |
| Bitewing x-rays (set of 4) |
$0 copay (1 set every year) |
| Periapical x-rays |
$0 copay |
| Panoramic or complete series x-rays |
$0 copay (1 set every 60 months) |
Members are responsible for any amount above the plan allowed amount for out-of-network covered service.
Sound + Rx HMO and Charter + Rx HMO
| Benefits |
Allowance |
| Office visit |
$20 copay |
| Routine oral exams |
$0 copay (2 every year) |
| Routine cleanings |
$0 copay (2 every year) |
| Fluoride treatments |
Not covered |
| Bitewing x-rays (set of 4) |
$0 copay (1 set every 6 months) |
| Panoramic or complete series x-rays |
$0 copay (1 set every 36 months) |
Sound + Rx HMO and Charter + Rx HMO do not offer out-of-network dental benefits with embedded dental. These plans provide access to hundreds of local dentists with the Premera Medicare Advantage Select Dental network.
Dental Riders
Optional preventive dental coverage can be added as a rider to the HMO and Core HMO for $26 per month within 60 days of a plan’s start date or during the annual enrollment period.
No dental rider is available for Peak + Rx HMO and Alpine HMO.
Medicare Advantage resources page
You always have resources at your fingertips to sell Premera Medicare Advantage. Just go to our online Medicare Advantage resource page for producers.