If you have a Medicare Advantage plan in Florida and you've been putting off fixing your teeth, 2026 is the year. This year's plans have the most generous dental coverage we've seen — especially for dentures and implants. But there's a catch: if you don't use your benefits before December 31, you lose them. They don't roll over.
Most Medicare Advantage beneficiaries in Miami-Dade have between $2,000 and $10,000 in annual dental benefits. And more than half don't use them. That's real money your plan already paid for you — and it vanishes on January 1st.
Two cleanings per year, exams, X-rays, and fluoride. Most plans have no copay for these. If you haven't been to the dentist in years, start here — it's literally free with your plan.
Fillings, simple extractions, gum treatment (scaling and root planing). If you have periodontitis — and 65% of adults over 65 do — a full gum treatment can cost $1,000-$2,000. With a DSNP plan, your copay can be close to zero.
This is where dentures and implants live. Coverage varies significantly between plans:
Complete dentures: Cost $1,500-$3,000 without insurance. Florida Medicare Advantage plans cover between 50-80%, depending on the plan. A quality set of dentures could cost you $300-600 out of pocket with MA coverage.
Dental implants: New for 2026 — several premium plans now cover implants for the first time. An individual implant costs $2,000-$4,000. With coverage, your share could be $800-$1,600. Not all plans cover it, so check yours.
Implant-supported dentures: The best option for people who don't want removable dentures that slip. Two or four implants anchor a fixed denture. Total cost $8,000-$15,000. With MA, you can cover a significant portion — especially if you combine the dental benefit with the health allowance.
If you have Medicare AND Medicaid at the same time (dual eligible), you qualify for a DSNP (Dual Special Needs Plan). These plans have the best dental coverage in Florida:
DSNP plans from Humana Gold Plus, Simply Healthcare, WellCare Medicare, and CarePlus offer expanded dental coverage with minimal or zero copays for most preventive and basic procedures. For major services like dentures, copays are significantly lower than a standard MA plan.
If you think you might qualify for dual eligibility, ask your Medicare provider or your county social worker. Many people who qualify don't know it.
Step 1: Call the number on the back of your MA card and ask exactly what your annual dental benefit is, what percentage they cover by category (preventive, basic, major), and what your annual maximum is.
Step 2: Schedule your cleaning and exam as soon as possible. This is free and lets the dentist create a complete treatment plan.
Step 3: If you need major work (dentures, implants, gum treatment), request a detailed estimate and submit it to your plan for pre-authorization. This confirms what they'll cover before you start.
Step 4: Plan your treatment to complete it before December 31. Benefits reset on January 1 — what you didn't use, you lost.
At PureSmile Miami, we work with most Medicare Advantage plans in Florida, including Humana, Simply, WellCare, CarePlus, and DSNP plans. Our team helps you verify your exact coverage before starting any treatment — no surprises.
We speak English and Spanish. If your dental benefits have been sitting unused for years, schedule a first visit. We'll tell you exactly what your plan covers and what comes out of your pocket. That first consultation costs you nothing with MA.
