Does WellCare Pay for Dentures?

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Russell Noga
by Russell Noga | Updated February 5th, 2024

If you’re inquiring about WellCare’s dental coverage for dentures, we have your answer: does WellCare pay for dentures? Yes, WellCare’s dental plans typically include denture coverage, subject to specific plan rules and limitations. This article will provide you with essential information on how to confirm your eligibility, understand the nuances of the coverage, and navigate WellCare’s offerings for dental care.


Key Takeaways

  • WellCare provides comprehensive dental coverage, including for major restorative services like dentures; however, it’s essential to understand specific plan limitations, eligibility criteria, and exclusions by reviewing the Evidence of Coverage document.
  • WellCare emphasizes preventive dental care, offering services such as routine exams, cleanings, and fluoride treatments to maintain oral health, with regular visits helping identify and prevent more serious issues.
  • Maximizing dental coverage benefits with WellCare involves choosing in-network dentists and fully utilizing preventive and comprehensive services available within the plan, while staying informed on annual coverage changes.


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Understanding WellCare's Dental Benefits

 Understanding WellCare's Dental Benefits


WellCare stands tall in the field of dental insurance, extending a wide array of plans to cater to diverse dental needs. From the WellCare Medicare Dental PPO to the WellCare Medicare Dental HMO, the options are varied and comprehensive. What’s even more impressive is that these plans encompass coverage for major restorative services, including dentures.

But how do you navigate the finer details of these plans? The key lies in your Evidence of Coverage document, a treasure trove of information that maps out the specifics of what your plan covers and how much it pays for different dental services.


Coverage for Dentures Under WellCare

WellCare’s dental plans are comprehensive, providing coverage for dentures as an integral part of their dental coverage. Although it’s reassuring to know that dentures are included in the coverage, be cognizant of possible specific limitations on the amount WellCare will pay for certain services.

Equally important is understanding the exclusions to denture coverage. Procedures not specified in the dental schedule of benefits, or those deemed unnecessary based on the professional opinion of the provider, usually fall outside the coverage umbrella. Keep in mind, fully understanding these nuances is the key to optimizing your benefits.


Eligibility Criteria for Denture Coverage

What determines denture coverage eligibility? The most important criterion is medical necessity. Dentures should be needed to maintain oral health, chewing function, or speech for WellCare to cover the cost.

Moreover, the plan you choose plays a pivotal role in dictating eligibility for denture coverage. With a variety of WellCare plans offering a spectrum of preventive and comprehensive dental services, denture coverage becomes an accessible benefit for customers. However, for WellCare to cover the cost of partial dentures, remember to visit your designated participating provider.


How to Check Your Plan for Denture Coverage

Grasping the subtleties of your WellCare dental coverage is vital for maximizing its potential benefits. Having your Evidence of Coverage or plan details handy is the first step. Familiarity with specific terms related to denture coverage, such as ‘supplemental dental benefits,’ also helps you grasp your plan’s provisions for dentures.

To review your dental coverage, including how much WellCare pays for specific dental services, you need to navigate the WellCare portal. Here are the steps to follow:

  1. Choose your plan
  2. Log in or register for an account
  3. Utilize the portal’s features such as checking member eligibility, submitting authorizations and claims, and accessing training.

If you’re more comfortable speaking with someone, you can contact WellCare customer service at 1-866-822-1339 to inquire about your dental coverage for dentures. You can also examine your Summary of Benefits to determine if dental services, specifically dentures, are covered, or explore information on the WellCare website regarding dental providers.

Maximizing Your Oral Health with WellCare

 Maximizing Your Oral Health with WellCare


Good oral health goes beyond merely having a sparkling smile. It’s an integral part of your overall health, underscoring the need for routine dental care and preventive services.

With WellCare’s dental coverage that prioritizes preventive care services like routine cleanings and exams, maintaining optimal oral health becomes less daunting.


Preventive Care Services Offered

WellCare’s preventive care services include:

  • Routine dental exams
  • Teeth cleanings
  • X-rays
  • Fluoride treatments
  • Dental sealants

These services are designed to keep your oral health in check and maintain a healthy smile.


Importance of Regular Dental Visits

Regular dental visits serve as more than just a routine; they pave the way towards optimal oral health. These appointments enable seniors to identify and prevent dental issues before they escalate in severity. Therefore, senior citizens, the primary customer base of WellCare, are advised to schedule a dental appointment at least twice a year.

Routine dental visits can aid in early detection and prevention of oral health issues including tooth decay, gum disease, tooth loss, and oral cancer. With WellCare’s commitment to facilitating access to high-quality dental care, preventive measures like routine check-ups and cleanings, as well as fundamental restorative services like fillings and extractions, become more accessible. A typical dental check-up involves teeth cleaning, thorough examination by the dentist, and review of x-rays, among other procedures.



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Additional Dental Services Covered by WellCare

Additional Dental Services Covered by WellCare


In addition to preventive care services and denture coverage, WellCare extends its coverage to include a range of additional dental services. Whether it’s basic restorative services like re-cement or re-bond of dental restorations or major dental procedures like crowns, bridges, and dentures, WellCare leaves no stone unturned in offering comprehensive dental coverage.


Basic Restorative Services

WellCare’s coverage for basic restorative dental services is comprehensive. It includes dental fillings and extractions, providing customers with diverse solutions for maintaining their oral health. For specific procedures like dental extractions, WellCare provides coverage for the removal of erupted teeth and coronal remnants-deciduous tooth.

Root canals, often dreaded but necessary, also fall within WellCare’s coverage for basic restorative services. However, to make the most of these benefits, it’s advisable to consult the plan’s booklet for a comprehensive understanding of covered services and any associated limitations.


Major Dental Procedures

WellCare’s coverage for major dental procedures provides a safety net for those unexpected dental issues. Whether it’s teeth prepared for crowns, root canals in progress, or full or partial dentures for which an impression has been taken, WellCare offers a dynamic coverage plan.

What’s more, WellCare does not impose a coverage limit for major dental procedures, providing flexibility in the covered treatments. However, to understand the potential cost of major procedures like a root canal or dental crowns, it’s advisable to consult WellCare directly for precise figures on how much they will cover for these services.

How to Save on Dental Costs with WellCare

How to Save on Dental Costs with WellCare


As you explore the realm of dental coverage, finding cost-effective solutions without sacrificing quality is paramount. With WellCare, you can do just that. By visiting a dentist within WellCare’s network, you can access preventive and comprehensive dental services at a reduced cost.


Choosing an In-Network Dentist

The decision to choose an in-network dentist, while seemingly insignificant, can have a substantial effect on your dental costs. An in-network dentist is a dental professional who is affiliated with the WellCare network and agrees to accept WellCare insurance plans.

To find an in-network dentist, you can use the WellCare Find a Provider tool on their official website. Select ‘specialty,’ choose ‘dentistry,’ and click ‘Go to Results’ to view a list of WellCare dental providers within your search area. By doing so, you can enjoy reduced out-of-pocket expenses for dental services, thereby enabling cost savings on your dental procedures.


Taking Advantage of Full Coverage

WellCare’s full coverage is a comprehensive package that includes preventive care services like regular check-ups, cleanings, and basic restorative services like fillings. To optimize these benefits and reduce personal expenses, utilize preventive services, which are covered at no cost. You may also consider WellCare Medicare Advantage plans for potentially lower out-of-pocket costs and a reduced out-of-pocket maximum compared to Original Medicare.

However, it’s important to be aware of potential limitations associated with WellCare’s full dental coverage. These limitations may encompass:

  • Restrictions
  • Exclusions
  • Annual limits on routine dental care services
  • Generally do not cover foreign services unless deemed necessary in an emergency scenario.

Finding the Right Dental Plan for You

Finding the Right Dental Plan for You


Selecting the appropriate dental plan can be as challenging as finding a needle in a haystack. With numerous options and countless considerations, making the right choice can be overwhelming. But with WellCare, you don’t have to navigate this journey alone. By understanding your dental requirements, comparing WellCare Medicare Dental Plans, and considering your budget, you can find a dental plan that fits like a glove.


Comparing Different WellCare Plans

WellCare offers an array of dental plans to cater to diverse needs. The plans offer a wide range of preventive and comprehensive coverage, including dental exams, x-rays, cleanings, and prosthodontics. This ensures that individuals have access to a variety of services to meet their specific needs. There are two prominent plans offered by WellCare: the WellCare Medicare Dental PPO and the WellCare Medicare Dental HMO plans..

While both plans offer diverse services, they differ in the scope of covered services and the network of providers. The PPO plan offers greater flexibility in provider selection, whereas the HMO plan may offer more limited choices at a reduced cost. Also, it’s important to consider the plan’s cost, including deductibles, copayments, or coinsurance, which can significantly impact the overall affordability of the plan.

When assessing a plan, considering the network of providers by examining the quantity, geographical distribution, range of services provided, and the standard of care is crucial.


Applying for a WellCare Dental Plan

Once you’ve found the right WellCare dental plan, the next step is to apply. The application process can be initiated by visiting the official WellCare website or reaching out to their customer service for comprehensive guidance.

The documentation necessary for the application varies but typically includes evidence of any qualifications that influence approval, such as medical necessity and suitability of requested services. You can apply for a WellCare dental plan online through the official WellCare website. The processing time for a WellCare dental plan application is approximately 10 calendar days.

Keeping Up with Updates to Dental Coverage

Given the constantly changing nature of dental insurance, keeping abreast of coverage changes is of utmost importance. WellCare makes this easier by dispatching an Annual Notification through postal mail, which outlines any updates, including those pertinent to dental plans.


Checking for Annual Changes

WellCare generally evaluates and modifies their dental coverage on an annual basis. These modifications encompass changes to:

  • the coverage of services
  • benefits
  • coverage rules
  • costs

Members are informed about these changes through the Annual Notice of Changes, which provides details on any modifications to benefits, costs, and rules.

However, to avoid overlooking crucial updates or changes in coverage, it’s advisable to stay informed about any modifications to your WellCare Medicare Dental plan. This proactive approach can help you stay ahead of the curve and make the most of your dental coverage.


How to Receive Updates from WellCare

Keeping informed about your dental coverage isn’t a one-off task, but rather an ongoing endeavor. With WellCare, you have numerous ways to receive updates. You can:

  • Refer to your plan documents
  • Directly reach out to WellCare
  • Enroll in a WellCare plan online, over the phone, at a local event, by mail, or through a broker.

For updates on dental coverage, you can contact WellCare at the dedicated line 1-866-822-1339. However, the frequency of updates to WellCare’s dental coverage plans is not specified, so it’s recommended to regularly check for updates.


In the labyrinth of dental insurance, understanding your benefits is critical. With WellCare, you have a comprehensive range of dental services, preventive care, and major dental procedures at your disposal. Choosing an in-network dentist and understanding your plan’s details can help you make the most of your coverage. Keeping track of updates and changes in your coverage can help you stay ahead of the curve. With proactive steps and informed decisions, you can ensure your smile remains as bright as ever.

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Frequently Asked Questions

Does Kentucky Medicaid pay for dentures?

Yes, Kentucky Medicaid will pay for dentures as part of the expanded dental benefits for adults announced by Governor Beshear, starting in 2023.


What can you buy with the Wellcare OTC card?

With your Wellcare OTC card, you can buy everyday personal care and wellness products such as vitamins, bandages, and toothpaste without leaving your home, as it provides a fixed dollar amount for these purchases. This is one of the money-saving benefits of Medicare.


Does wellcare cover dental?

Yes, Wellcare provides coverage for preventive, basic, and major dental services, as well as emergency dental care and oral surgery, including orthodontic services. This ensures access to the necessary dental care without concerns about cost.


What are the benefits of visiting a dentist within WellCare’s network?

Visiting a dentist within WellCare’s network can provide coverage for preventive and comprehensive dental services, leading to cost savings on your dental procedures. This can help you maintain good oral health without breaking the bank.


Speak to the Professionals about Medigap Plans and Original Medicare

If you find understanding the benefits involved with Original Medicare and Medigap Plans challenging, you’re not alone. Whether it’s a Medigap plan, or you want to know more about WellCare’s dental coverage for dentures, we can help. Call our team at 1-888-891-0229 for a free consultation or complete the contact form on this site, and an expert will call you back at a convenient time.

We have decades of experience advising our clients on the complexities of Medicare and Medigap plans, the benefits, cost and deductibles. We’ll ensure you get the best rate in your state and advice you can trust.

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