Purpose
Understand what Medicare covers in Florida for dental services in 2026, identify the patient's correct plan, and process appropriately.
Three main types
| Type | Card | ID | Dental coverage |
|---|---|---|---|
| Original Medicare | Red/white/blue paper | 11 alphanumeric digits (e.g. 1EG4-TE5-MK72) | Limited — only oral surgery related to other medical conditions |
| Medicare Advantage (Part C) | Plastic from private insurer | Varies by carrier | Varies — some include full dental benefits |
| Medicaid (Florida) | State or contracted private | Varies | Limited in adults; better pediatric coverage |
How to identify the patient
1. Ask for the card
If red/white/blue paper card = Original Medicare. Very limited dental.
2. If plastic card
Identify the carrier logo:
- Humana
- UnitedHealthcare
- Aetna
- Wellcare
- Sunshine Health (Centene)
- Simply Healthcare
It's Medicare Advantage. Dental coverage varies by plan.
3. Yellow card issued by state
It's Florida Medicaid. Process as such.
Common Medicare Advantage carriers in Florida
| Carrier | BrandaCare notes |
|---|---|
| Humana | Supports 276/277 via Stedi. Decent dental coverage |
| UnitedHealthcare | "Cannot provide further status electronically" on 276 — use manual portal |
| Aetna | Does NOT accept 837D via Stedi. Use alternative channel |
| Wellcare | Variable |
| Sunshine Health (Centene) | More common in Medicaid |
Attention: If patient only has Original Medicare (red/white/blue) and needs dental service NOT related to another medical condition → NO federal coverage. Process as self-pay or discount plan.