ER
Eduard Rubakha
Sep 12, 2025
My Experience with Medicare Advantage Dental Coverage.
After retiring in January 2025, I enrolled in a Medicare Advantage plan that includes dental coverage. The plan covers preventive services such as oral exams, routine cleanings, X-rays, and fluoride treatments, but only in full if performed by in-network dentists.
For nearly 20 years prior to retirement, my family and I relied on Frisco Family Dentistry for all of our dental needs. They consistently provided excellent preventive care, twice yearly cleanings, and any necessary treatments to keep our teeth and gums healthy. We trusted their expertise and always maintained good oral care at home. Unfortunately, Frisco Family Dentistry is not part of my Medicare Advantage network, so I searched for in-network alternatives.
My first visit was to Dental Arts of Frisco, which had positive reviews. They took 18 X-ray images, and the dentist presented me with a long list of recommended procedures, including deep cleaning at a cost of $800 (with a total treatment plan estimate of $5,000). None of this had ever been suggested at my recent visits with Frisco Family Dentistry. I requested only the standard cleaning covered by my plan. At first, they scheduled me for it, but later informed me that the appointment was a mistake and they would only perform the deep cleaning. I declined and instead went to Comfort Dental Frisco, where I was able to receive the standard cleaning.
A similar issue occurred with my wife. We scheduled her at Mapletree Family Dentistry, an in-network provider within walking distance of our home. She transferred her recent X-rays from Frisco Family Dentistry, where she had received a normal cleaning earlier this year. Despite that, the new dentist insisted she needed a deep cleaning costing $800, and refused to provide the preventive cleaning covered by Medicare. Once again, we returned to Frisco Family Dentistry out-of-network, where their evaluation found no signs of periodontitis or need for deep cleaning. She received a regular cleaning there, which we paid for out-of-pocket ($144).
From these experiences, I’ve concluded that some in-network providers participate in Medicare Advantage not for the preventive coverage payments, but primarily to attract new patients and then push costly procedures that are not covered.
My advice to other Medicare Advantage members:
Be cautious when in-network dentists recommend expensive treatments, especially if you have a history of good dental health. Don’t be pressured into unnecessary procedures — sometimes it’s worth paying out-of-pocket at a trusted provider for the care you truly need.
I have filed formal complaints with my Medicare Advantage provider regarding these practices, though I am unsure how effective the resolution will be.
TN
Tina Nguyen
Nov 12, 2023
The entire team, including Dr. Bang, was amiable, accommodating, extremely competent, and fantastic. In addition to being incredibly knowledgable about his work and the dental implant technique, Dr. Bang was also very kind and took his time to get the job done perfectly. I heartily urge everyone to check out Dr. Bang's dental implant work. I appreciate Dr. Bang's commitment, tolerance, and thoughtfulness throughout the implementation process.