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Navigating Medicare & Medicare Advantage (Dental) Plans

Speaker:

Dennis McHugh

June 1, 2024

Date:

3

CE Credits:

About the Course

Navigating Medicare & Medicare Advantage (Dental) Plans


ADA Staff receive many questions about Medicare Advantage (MA) plans, also known as Part C plans and dentists have questions about participating in these types of plans. It is incumbent that dentists understand MA plans and how these plans may impact their practice. Dentists will learn about the differences between Medicare and Medicare Advantage, how plans provide star ratings and supplemental offerings. Opting out of Medicare and preclusion/exclusion lists will be discussed. You will learn about the various Medicare Advantage products, e.g., DHMOs, PPOs and Allowance plans. Dentists will hear how patients utilize and what patients expect from their MA dental benefits. Dual-eligible members (Medicare and Medicaid) will be addressed. You will also hear how non-covered services are handled and the waiver of liability form (for out-of-network providers) will be discussed.

Educational Objectives


  • Learn the difference between Medicare and Medicare Advantage, also known as Part C plans, and how participation may affect a typical dental practice.

  • Gain a better understanding about star rating plans and supplemental benefits offered by Medicare Advantage plans.

  • Learn about the opt-out process, preclusion/exclusion lists and dual-eligible members (Medicaid and Medicare). In addition, network participation and non-covered services will be discussed.


Your Instructor

Dennis McHugh

Dennis McHugh is the senior manager for third party payer issues for the American Dental Association and works in the Practice Institute’s Center for Dental Benefits, Coding and Quality (CDBCQ). CDBCQ is the ADA agency responsible for promoting resources and information on dental benefit plans to employers and member dentists. In addition, CDBCQ responds to requests and helps resolve dental insurance problems from member dentists and helps answer questions regarding the CDT Code. He has been with the ADA for 24 years and prior to that spent 7 years working for the American Association of Orthodontists. Dennis graduated from Southeast Missouri State University with a Bachelor of Science degree in Business Administration and an Associate of Applied Science in Computer Science.

Conflict of Interest Disclosure

None reported





The TDA is an ADA CERP provider (May 2021 – June 2024)

ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to ADA CERP at ada.org/cerp.

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