We understand that for most Medicare beneficiaries, dental coverage is the topmost sought-after supplemental benefit. And, in planning for 2022, we’ve worked to expand our dental coverage options, giving members even more value.
Dental reimbursement allowance
A dental reimbursement allowance is offered for any service provided by any licensed dentist and is included on the following plans:
- Basic - $200 allowance
- Essential - $100 allowance
- Optimal - $200 allowance
Members with this benefit can use their allowance for preventive, comprehensive, and cosmetic dental services. Then claims can be mailed to Kaiser Permanente for reimbursement.
Preventive dental benefit
The preventive dental benefit is embedded coverage provided through Delta Dental of Washington (DDWA) and is included on the following plans:
- Key - $400 annual max
- Harbor - $400 annual max
- Centennial - $1,000 annual max
- Columbia - $1,000 annual max
With the preventive dental benefit, members pay $0 for preventive and diagnostic services from a participating DDWA provider, up to their annual maximum benefit amount. Services include oral examination, bite-wing X-ray, panoramic X-ray, or a complete series, routine preventive teeth cleaning, and fluoride treatments.
The DDWA Optional Supplemental Benefit (OSB)
The DDWA Optional Supplemental Benefit (OSB) is an add-on rider available to all our individual Medicare Advantage plan members. The OSB provides both preventive and comprehensive dental benefits of up to $1,500, which is the annual maximum benefit. If selected, a $54 per month premium will be added to the member’s Medicare Advantage plan premium.
Your Medicare Advantage clients can select and enroll for the OSB dental benefit rider when they enroll in their individual Medicare Advantage plan or within 30 days of the MA plan effective date. Whether making a MA plan change or not, members can add on the OSB dental benefit rider between October 15 and January 31. Requests to add the OSB dental benefit rider can be made by calling Kaiser Permanente Medicare Member Services, and coverage dates are as follows:
- Requests received on or before December 31 will have a January 1 effective date.
- Requests received on or after January 1 will have a February 1 effective date.
- Outside of the October 15 to January 31 timeframe, requests for adding on the OSB dental rider must be accompanied with a new plan enrollment, plan change, or be within 30 days of the MA plan’s effective date.
OSB enrollment - Key, Harbor, Centennial, or Columbia plan members
If a Key, Harbor, Centennial, or Columbia plan member with embedded preventive dental coverage also chooses to enroll for the OSB dental benefit rider, the OSB will serve as their primary dental coverage. The embedded preventive dental coverage will not kick in until their OSB dental benefit or service limits are exhausted.
Members can request to cancel their OSB dental benefit rider at any time. After we receive the request, benefit cancellation will be effective the first of the following month.
Read more about OSB dental coverage. If you have additional questions, contact our Medicare Sales Producer Support Team: 1-800-581-8252, Monday through Friday, 8 a.m. to 5 p.m., or KPWA.Medicare@kp.org.