Every year, Medicare Advantage dental plans make changes — and they can be significant. One year, some plans covered implants; the next year, that coverage disappeared. One year, some plans paid 100% even for out-of-network providers; the next year, many states lost that benefit. Many carriers already announced big changes are coming 2026.

Why this matters: If you don’t review and verify benefits at the start of the year, you won’t know what your patients actually have — and believe me, most seniors don’t understand these changes. My mother-in-law’s Aetna Medicare plan in New York was switched without her knowledge or understanding. Situations like this can leave patients confused and your practice at risk of being owed thousands of dollars if coverage isn’t verified.

Big changes for 2026 include:

• Some carriers will no longer cover periodontal maintenance on their preventive-only plans.
• Some carriers will introduce co-insurance or reduce overall coverage.
• Some carriers will reduce their PPO dental plan offering.

What you can do now:

• Start reviewing plans that may become available before the new year.
• Build those plans in your PMS so you are ahead of the game.

Why verifying benefits is crucial: If you rely on 2025 benefits information on January 2, 2026, you will be completely out of date — some patients may have coverage changes, reduced benefits, or no coverage at all in your office. Verifying benefits ahead of time allows you to have accurate, up-to-date information in your system so you can clearly communicate with patients and avoid surprises for both them and your practice.