Highmark Dental 2027: Medicare Advantage Coverage for Seniors and How to Find a Dentist
Reviewed October 20, 2026. Highmark dental coverage for seniors on Medicare comes through Highmark Medicare Advantage plans. For 2027, Highmark says its Medicare Advantage plans include “Dental coverage with $0 copay for routine dental exams & routine dental cleanings twice per year.” Some plans also pay toward comprehensive work such as fillings and crowns, up to a yearly allowance, for example $2,000 in the 2027 Complete Blue PPO Signature plan in western Pennsylvania.
Quick answer: Original Medicare doesn’t cover routine dental care, so Highmark dental coverage for Medicare members depends on the Highmark Medicare Advantage plan you choose. Check the “Dental” rows of the plan’s 2027 Summary of Benefits for preventive copays, comprehensive coinsurance and the yearly maximum, and find dentists in Highmark’s National Medicare Advantage Dental directory (United Concordia). You can change plans during Medicare Open Enrollment, October 15 to December 7, 2026. Benefits vary by plan and county.
Does Medicare cover dental?
Mostly no. Medicare.gov says Original Medicare doesn’t cover “dental services like routine cleanings, fillings, tooth extractions” in most cases, or dentures and implants. It covers limited dental care only when it’s tied to certain covered medical treatment or an inpatient hospital stay (Medicare.gov: Dental services). That’s why seniors look to Medicare Advantage plans, such as Highmark’s, or standalone dental insurance. Read more in why Medicare doesn’t cover dental care.
Highmark Medicare Advantage dental in 2027
Highmark’s October 1, 2026 announcement says it will stay in all the states and counties it served in 2026 and that its plans include $0 routine exams and cleanings twice a year (Highmark, 2027 Medicare Advantage). Highmark Blue Cross Blue Shield serves western and northeastern Pennsylvania, Delaware, West Virginia and western New York; Highmark Blue Shield serves central and southeastern Pennsylvania and northeastern New York.
2027 Highmark dental by plan
| 2027 plan | Area | Routine (exams, cleanings, X-rays) | Comprehensive | Yearly maximum |
|---|---|---|---|---|
| Complete Blue PPO Signature (PPO) | Erie, Fayette, Indiana, Lawrence, Mercer and Westmoreland counties, PA | $0 in network, twice a year | 30% coinsurance in network | $2,000 combined |
| Freedom Valor (PPO) H5526-023 | Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans and Wyoming counties, NY | $0 in network | 50% coinsurance | $2,000 combined |
Sources: Highmark 2027 Summaries of Benefits for Complete Blue PPO Signature and Freedom Valor (Highmark document hosted by medicareadvantage.com). Both plans have a $0 monthly premium in 2027, and both list a $35 copay for Medicare-covered dental services. Complete Blue PPO Signature also covers out-of-network routine care at 30% and comprehensive care at 50%. Confirm details in the plan’s Evidence of Coverage before you get major work done.
2026 vs 2027: what changed?
Highmark’s dental structure looks similar year to year in the plans we compared. In 2026:
| 2026 plan | Premium | Routine dental | Comprehensive and maximum |
|---|---|---|---|
| Community Blue Medicare HMO Signature (Western NY) | $0 | $0 for 2 routine visits and 1 X-ray | 50% coinsurance; $2,000 allowance (comprehensive) |
| Community Blue Medicare HMO Distinct (Western NY) | $55 | Covered | $1,500 allowance (preventive and comprehensive combined) |
| Freedom Blue PPO ValueRx / Select / Classic (Western PA) | $79 / $139 / $248 | $15 copay per visit in network (2 exams and cleanings, 1 X-ray a year) | Medicare-covered dental $30 / $40 / $25 |
Sources: Highmark 2026 Summaries of Benefits for Western NY Community Blue Medicare HMO and Western PA Freedom Blue PPO. Read your 2027 Annual Notice of Change to see exactly what changes for your plan on January 1, 2027.
Highmark dental providers: how to find a dentist
Highmark’s Find a Dentist page says: “For Medicare Advantage plans, please search the National Medicare Advantage Dental directory.” That link opens the United Concordia dentist search for Highmark Medicare Advantage (Highmark: Find a Dentist).
- Open the directory and search by ZIP code.
- Call the dental office to confirm it’s in network for your specific Highmark Medicare Advantage plan.
- Ask for a treatment estimate before major work, so you know how much of your yearly maximum it uses.
Going in network matters: in the 2027 PPO plans above, out-of-network comprehensive care costs more.
Highmark dental coverage for seniors: how to use it well
- Use your two free cleanings. Routine exams and cleanings are $0 in network in 2027 Highmark plans.
- Plan big work around the yearly maximum. If a crown or bridge would go over the $2,000 limit, ask your dentist about splitting treatment across plan years.
- Know what isn’t covered. Check the Evidence of Coverage for limits on implants, dentures and cosmetic work.
- Compare other extras too. Highmark plans also include OTC allowances; see our Highmark OTC guide. For more Pennsylvania options, see Pennsylvania Medicare Advantage plans.
If you’re comparing carriers, see how other plans handle dental in Aetna Medicare dental 2027, Humana dental plans for seniors 2027 and UnitedHealthcare dental for Medicare members.
Highmark Medicare phone numbers
- Licensed Medicare adviser (prospective members): 1-800-318-1487 (TTY 711), from Highmark’s 2027 announcement
- Highmark Customer Service: 1-800-241-5704
- Freedom Blue PPO members: 1-800-550-8722
- Complete Blue PPO Signature members: 1-833-227-9375; new enrollment 1-866-746-7971
- Freedom Valor members: 1-800-329-2792
If you’re already a member, the number on your ID card is the best one to call.
Frequently asked questions
Does Highmark Medicare Advantage cover dental?
Yes. For 2027, Highmark says its Medicare Advantage plans include $0 routine dental exams and cleanings twice a year. Coverage for fillings, crowns and other work depends on the plan.
What is the Highmark dental yearly maximum for 2027?
It depends on the plan. Complete Blue PPO Signature and Freedom Valor list a $2,000 combined yearly maximum in 2027.
Who are Highmark’s Medicare Advantage dental providers?
Highmark points Medicare Advantage members to the National Medicare Advantage Dental directory run through United Concordia. Search it by ZIP code and confirm with the office.
Does Highmark offer dental insurance for seniors without Medicare Advantage?
Highmark’s Medicare dental benefits described here come with its Medicare Advantage plans. If you have Original Medicare, ask Highmark or a licensed agent about standalone dental plans available in your area.
Can I switch to a Highmark plan for better dental coverage?
You can change Medicare Advantage plans during Open Enrollment, October 15 to December 7, 2026, for coverage starting January 1, 2027. Compare the dental section of each plan’s Summary of Benefits.
This article is general information, not plan-specific advice. Benefits vary by plan and county; check your plan’s Summary of Benefits and Evidence of Coverage. Medicare365 is not affiliated with Highmark, United Concordia, the Blue Cross Blue Shield Association or the U.S. government.
Official sources
- Highmark: Highmark remains committed to Medicare Advantage members in 2027
- Highmark 2027 Summary of Benefits: Complete Blue PPO Signature (PDF)
- Highmark 2027 Summary of Benefits: Freedom Valor H5526-023 (PDF)
- Highmark 2026 Summary of Benefits: Western NY Community Blue Medicare HMO (PDF)
- Highmark 2026 Summary of Benefits: Western PA Freedom Blue PPO (PDF)
- Highmark: Find a Dentist
- Medicare.gov: Dental services