Your Smile Matters

Dental We’re happy to offer quality dental services to our EmblemHealth VIP Medicare members. Having healthy teeth is part of staying healthy.

Our goal at EmblemHealth is to provide you with access to high-quality care, which is why we have contracted with DentaQuest to manage the dental needs of our EmblemHealth VIP Medicare members. DentaQuest has a large network of participating dentists and specialists.

Preventive and Comprehensive Benefits

As an EmblemHealth VIP Medicare Member, you will pay $0 for preventive services like cleanings, x-rays, exams and fluoride treatments. For comprehensive dental services you will pay $0 to $150 depending on the service. There is no annual dollar limit.

All of our EmblemHealth VIP Medicare Plans include preventive dental services. Plans that include Comprehensive Dental Benefits are our EmblemHealth VIP Dual (HMO SNP), EmblemHealth VIP Essential (HMO), EmblemHealth VIP Rx Saver (HMO), EmblemHealth VIP Go (HMO-POS), EmblemHealth VIP Gold (HMO) and EmblemHealth VIP Gold Plus (HMO).

As a member of the EmblemHealth VIP Dual (HMO SNP) you pay $0 for both preventive and comprehensive dental services

Optional Supplemental Benefit for Comprehensive Dental

EmblemHealth VIP Value (HMO) and EmblemHealth VIP Part B Saver (HMO) include preventive dental benefits and offer an optional supplemental benefit for comprehensive dental benefits. The cost for this optional benefit is $11.50 monthly.

For more information about dental services and participating dentists and specialists please call EmblemHealth Dental at 844-776-8749, 8 am to 8 pm, Monday to Friday. If you use a TTY, please call 711, 8 am to 8 pm, Monday to Friday.

Please see the chart for what you will pay and covered services.

All Other Plans EmblemHealth VIP Dual (HMO-SNP)
Preventive Dental Benefits You Pay You Pay
Routine Cleaning/1 every 6 months $0 $0
Fluoride application; Fluoride treatment/1 every 6 months $0 $0
Single tooth X-rays; Bitewing X-rays/ 1 every 6 months $0 $0
Periodic Oral Exam; Limited Oral Exam/1 every 6 months $0 $0
Comprehensive Dental Benefits
Restorative
Fillings/1 every 24 months $0 $0
Recement Crown (covered after 6 months) $0 $0
Prefabricated Stainless Steel Crowns/1 every 60 months $0 $0
Post and Core in Addition to Crown/ 1 every 60 months $0 $0
Inlay/Onlay and Single Crown Restoration/1 every 60 months $125 $0
Endodontic/Periodontic/Extractions
Therapeutic Pulpotomy/1 per lifetime $0 $0
Root Canal (molar) Once per permanent tooth per lifetime $20 $0
Root Canal (except molar)/ 1 per lifetime $0 $0
Gingivectomy/Gingivoplasty per Quadrant /1 every 36 months $20 $0
Osseous surgery – (1-3 teeth) per Quadrant/ 1 every 60 months $75 $0
Osseous surgery – (4 or more teeth) per Quadrant/ 1 every 60 months $150 $0
Periodontal Maintenance/1 every 36 months $0 $0
Apicoectomy/Periradicular Services/ 1 per lifetime $20 $0
Scaling and root planing/1 every 36 months per quadrant $20 $0
Prosthodontics, Oral/Maxillofacial
Complete or Partial Denture/ 1 every 60 months $150 $0
Complete Denture Repair/1 every 12 months $0 $0
Complete Denture Rebase and Reline/1 every 36 months $0 $0
Fixed Partial Denture Pontics, Retainers, Recement/1 every 60 months $150 $0
Extraction or Removal of Tooth – Soft Tissue/1 per lifetime $0 $0
Removal of Bony Impacted Tooth/ 1 per lifetime $50 $0
Other Surgical Procedures/ 1 per lifetime $50 $0
Alveoloplasty without Extraction – per Quadrant/1 every 12 months $0 $0
Excision, Incision and Other Repair Procedures $50 $0
Vestibuloplasty – 1 arch per lifetime $50 $0

*Implants are not covered by our plan

Preventive and Comprehensive Dental from EmblemHealth Download PDF
Dental Brochure

This information is not a complete description of benefits. Call 877-344-7364 TTY: 711 for more information.