UPMC Dental Advantage: Flexible, Affordable Dental Coverage in Pennsylvania

UPMC Health Plan has long provided Pennsylvanians with access to high-quality health care and service to match. The same is true for its dental insurance in PA, which is now bundled with vision and medical coverage for plans in the UPMC Partner, Select, and Premium networks at all metal levels for Individual and Family plans. 

UPMC Dental Advantage plans are packed with offerings you might not find in other plans, including the local expertise that comes with always being based in the state. This affordable dental insurance also gives you flexibility from the start with these features:

• Access to a large network of providers
• No waiting periods 
• Coverage for pre-existing oral health conditions 

Why Choose UPMC Dental Advantage?

All UPMC Dental Advantage plans are PPO dental insurance, bundled with vision and medical coverage for plans in the UPMC Partner, Select, and Premium networks at all metal levels. That means you can take advantage of these features: 

• No need to choose a primary dentist
• No ID card required to receive services (provide the dental office with basic information to verify your eligibility for care)
• No waiting period for care
• No denial of coverage or benefits because of a pre-existing dental condition
• No prior authorization required for major services
• Enhanced benefits that include one additional cleaning during pregnancy, nonsurgical periodontal care, and coverage for microbial tests and brush biopsies
• Preventive services, such as cleanings, exams, and x-rays, are not counted toward the benefit maximum in most plans, leaving more benefit dollars for other covered dental procedures

Shop for a dental plan

 

Plan Options to Fit Your Needs

UPMC Dental Advantage offers Basic, Standard, and Premium plan options[. Having UPMC Health Plan dental insurance gives you access to a vast network of dentists and much more. Compare each plan to see which option will work best for you.

Review complete plan information to learn about waiting periods, coverage, costs, and exclusions.

Trusted Dental Providers Across Pennsylvania—and Nationwide

Our plans give you access to a large network of UPMC Dental Advantage providers across Pennsylvania and nationwide. The large footprint of the UPMC Dental Advantage network helps ensure that you get can care when and where you need it.

Find UPMC Dental Advantage providers in Pennsylvania

 

Continuity of Care: Already in Treatment? No Problem.

It is important to choose dental insurance with no waiting period, especially if you are in the middle of receiving dental work. No matter which UPMC Dental Advantage option you choose, you get a dental plan with no waiting period and no denial of coverage or benefits because of a pre-existing condition. That means if you or a dependent is already receiving treatment for a dental issue, you can continue getting that care under a UPMC Dental Advantage plan. 

What happens if I’ve already started a crown or root canal?

UPMC Dental Advantage reimburses for certain endodontic work that treats pulp and root issues inside of the tooth, depending on the situation. If your root canal was completed before you were covered under UPMC Dental Advantage, your previous dental plan is responsible for the paying the claim. If the work was completed after your UPMC Dental Advantage coverage started, then UPMC Dental Advantage will cover the cost.

Will I lose orthodontic benefits if I switch plans mid-treatment?

If you switch to a UPMC Dental Advantage plan that covers orthodontics for your child, they will not lose their orthodontic benefits. If they are already receiving orthodontic treatment, like braces, their orthodontist will still receive the rest of the benefit from UPMC Dental Advantage. Your plan will pay the benefit gradually over the course of your child’s treatment.

What documentation is needed to continue care with a new plan?

This will depend on whether you are continuing care for services like a root canal, crown, or orthodontics. In general, your dentist’s office typically needs to give UPMC Dental Advantage the expected treatment timeline and other general information to help determine coverage eligibility and payment responsibility.

UPMC Dental Advantage FAQs

Is UPMC Dental Advantage part of Medicare?

Yes! UPMC Dental Advantage is built into UPMC for Life Medicare Advantage plans, which also include vision benefits and an allowance for hearing aids. (Please note that this bill in Congress aims to get hearing aids covered in Medicare.)

Does UPMC Dental Advantage insurance cover orthodontics?

UPMC Dental Advantage often covers orthodontic services for children, depending on the specific plan, treatment, and timing of the treatment. It is important to note that UPMC for Life Medicare Advantage plans typically do not include coverage for orthodontics. 

Can I keep my current dentist with a UPMC Dental Advantage plan?

You can keep getting care from your current dentist if they are part of the network for your UPMC Dental Advantage plan.  

What preventive care is included in UPMC Dental Advantage plans?

UPMC Dental Advantage plans are designed to encourage regular preventive care. They include coverage for exams, cleanings, bitewings, and x-rays.