Insurance & Billing
Our Mountain's Edge team helps you understand what your Medicare plan covers so you can get care with confidence and no billing surprises.
Original Medicare (Parts A and B) offers very limited dental coverage, which surprises many patients who assume routine dental care is included alongside their medical benefits. At Elevate Dental, our Mountain's Edge team helps you sort through the fine print so you know exactly where you stand before any treatment begins. Many of our patients carry a Medicare Advantage (Part C) plan that bundles supplemental dental benefits, and we work directly with those carriers to confirm what applies to your care.
Our insurance coordination team reviews your plan documents, checks your remaining annual allowance, and verifies which procedures your specific Medicare Advantage plan recognizes as covered - all before you ever sit in the chair. We believe you should never feel blindsided by a bill, so we build a written, itemized estimate for every recommended treatment plan.
If you carry Original Medicare without a supplemental dental rider, we will still walk you through self-pay and financing options so cost never becomes a barrier to the care you need. Transparency is the standard we hold ourselves to on every visit, not an exception.
Dental riders attached to Medicare Advantage plans vary widely by carrier and region, so coverage depends on your specific plan design. Below is a general guide to the categories of care most frequently included - we confirm your exact benefit levels before treatment starts.
Exact coverage levels, waiting periods, and annual allowances differ from plan to plan. Our front desk pulls your specific policy codes and confirms benefit tiers with your carrier before we finalize any treatment plan.
A handful of insurance terms drive most of what you pay out of pocket. Knowing these concepts up front helps you plan ahead and avoid surprises at checkout.
Most dental riders cap the dollar amount the plan pays each calendar year. Once you reach that cap, you're responsible for remaining costs until the plan resets.
Some plans require you to pay a set amount out of pocket before benefits kick in. Preventive visits are often exempt from this requirement.
In-network agreements set discounted rates for covered procedures, which lowers both the insurer's payment and your share of the cost.
Many plans cover one or two cleanings and exams per year at little to no cost, since preventive care reduces costly treatment later.
For major restorative work, plans typically split the cost with you by percentage rather than a flat copay, often 50% for major services.
For larger procedures, we can submit a pre-authorization request so you know your projected out-of-pocket cost before committing to treatment.
Our billing specialists handle the paperwork directly with your Medicare Advantage carrier so you can focus on your health, not forms.
Before your visit, we contact your Medicare Advantage carrier to confirm active dental benefits and remaining allowances.
Our dentists evaluate your oral health and outline a treatment plan matched against your plan's covered procedure codes.
You receive a written estimate showing what Medicare Advantage is expected to pay and what portion is your responsibility.
After treatment, we file your claim electronically so your carrier processes it as quickly as possible, with no paperwork for you to mail.
If a claim needs additional documentation, our team follows up directly with the carrier so you never have to chase down reimbursement.
Dedicated insurance advocacy protects your budget and takes the guesswork out of using your Medicare Advantage dental benefit.
We track your remaining allowance throughout the year and recommend timing for treatment so you use available benefits before they reset.
Our team files every claim on your behalf, directly with your carrier, so you never deal with reimbursement forms.
You know your projected cost before we begin treatment, with no hidden charges appearing afterward.
For balances not covered by your plan, we offer payment arrangements so needed treatment doesn't get delayed.
Medicare Advantage plans renew annually, and most dental allowances do not roll over. Any unused portion of your benefit simply disappears once the calendar year closes, which is why we encourage patients to schedule remaining cleanings, restorative work, or follow-up care in the fall rather than waiting until January.
If you need extensive treatment that exceeds your annual maximum, we can often phase the plan across two calendar years, scheduling part of the work in December and the remainder in January so each portion draws from a fresh annual allowance.
If you also hold a health savings account or flexible spending account, those pre-tax funds can bridge the gap between what Medicare Advantage covers and your remaining balance, often reducing your true out-of-pocket cost. Our front desk can tell you whether a given procedure qualifies.
A few proactive steps can stretch your coverage further and reduce what you pay out of pocket.
Our front office is always glad to sit down with you and interpret the specific language in your plan documents - call anytime with questions.
"We tell every Medicare patient the same thing: no treatment moves forward until you know the cost. That promise has not changed since we opened our doors in Mountain's Edge."
Answers to the questions Mountain's Edge patients ask most about using Medicare for dental care at Elevate Dental.
Original Medicare Part A and Part B generally do not cover routine dental care, cleanings, fillings, or dentures. Coverage is typically limited to specific dental procedures connected to a covered medical treatment, such as certain jaw surgeries. If you want broader dental benefits, a Medicare Advantage plan with a dental rider is usually required.
Yes. We work with a range of Medicare Advantage carriers that include dental benefits as part of their plan design. Bring your Medicare Advantage ID card to your appointment, or call ahead, and our team will verify your specific dental benefit before you arrive.
Our insurance coordination team contacts your carrier directly to confirm your active benefits, annual maximum, and any waiting periods before your visit. We will share those details with you in plain language rather than leaving you to interpret insurance paperwork on your own.
Yes. For any treatment beyond routine preventive care, we prepare a written pre-treatment estimate that shows what your plan is expected to pay and what portion will be your responsibility. We do not move forward with major work until you have reviewed and approved that estimate.
If a recommended treatment falls outside your plan's coverage, we will clearly explain the out-of-pocket cost and discuss flexible payment arrangements. Many patients also use HSA or FSA funds to offset uncovered balances, and we can help you determine if that applies.
Most Medicare Advantage dental allowances reset annually and do not carry over unused amounts. We encourage patients to schedule any remaining treatment before the calendar year ends so available benefits are not left on the table.
Yes, our billing team submits claims electronically on your behalf after every visit. You will not need to fill out forms or mail anything to your carrier, and we follow up directly if your carrier requests additional documentation.
In some cases, patients carry a secondary dental policy alongside Medicare Advantage. Our team can coordinate benefits between the two plans and will explain the order in which each one applies to your treatment costs.
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10435 S Rainbow Blvd Ste A105 Las Vegas, NV 89178