Dental Care

You’ll have a variety of dental services covered with your Highmark Wholecare D-SNP. Here are some coverage highlights and details about using your dental benefits.

Preventive Dental Services

Preventive dental services help you maintain good dental hygiene and can help prevent future problems. Your Highmark Wholecare D-SNP covers preventive dental services, like:

• 1 oral exam every six months
• 1 cleaning every six months
• X-rays, including panoramic and full mouth x-rays once every 5 years

Non-Medicare Comprehensive Covered Dental Services

Your D-SNP offers dental coverage for care that isn’t usually covered by Medicare benefits, such as:

• White and silver fillings
• Simple extractions
• Denture repairs
• Treating deep decay to the nerve of the tooth
• Treating badly broken-down teeth with one crown in five years per tooth
• Gum disease treatment services (periodontal benefits) 

Dental Benefit Guidelines

Each Highmark Wholecare D-SNP offers its own benefit levels for dental care each year and some covered services with $0 copay. Also, D-SNP plans have different benefits for detail care, such as:

• Root canals
• Dentures
• Caps or crowns
• Deep cleaning of the teeth to remove deposits under the gums (scaling and root planning)
• Maintaining gum health through periodontal maintenance

Remember to check your D-SNP Evidence of Coverage (EOC) about dental benefits. 

Using United Concordia Dental Providers

Your dental benefits use the United Concordia network for some services. You must visit a dental provider in this network to receive D-SNP dental benefits for care like:

• Preventive and comprehensive dental services
• Root canals
• Dentures
• Periodontal root planning and scaling (smoothing roots and removing infected teeth)
• Full mouth debridement (removing damaged tissue or foreign objects from a wound)
• Periodontal maintenance (teeth cleaning to prevent disease)

Ask Us Dental Questions

If you have dental benefit questions or would like help finding a United Concordia dentist, please contact Member Services at 1-800-392-1147 (TTY 711).

Health benefits or health benefit administration may be provided by or through Highmark Wholecare, an independent licensee of the Blue Cross Blue Shield Association (“Highmark Wholecare”). Highmark Wholecare offers HMO plans with a Medicare Contract. Enrollment in these plans depends on contract renewal.

Medicare Ombudsman Website

Best Available Evidence

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_{Last Updated: Oct 1, 2024}