Medicare Advantage plan partners 

We're pleased to partner with leading health insurers who want to rely on South Dakota's largest and most experienced dental benefits provider for their Medicare Advantage plans. Our partners at Delta Dental of Michigan help us by providing their experienced claims processing and customer service for Medicare Advantage plans.

Below you'll find key information on Medicare Advantage plans in South Dakota that include dental benefits by Delta Dental of South Dakota.

Wellmark Blue Cross and Blue Shield

Wellmark Blue Cross and Blue Shield

Wellmark® Blue Cross® Blue Shield® includes dental benefits by Delta Dental of South Dakota in four Blue Medicare Advantage plans.

Dental coverage in these plans has changed for 2023:

  • All plans include comprehensive care and 50% coinsurance.
  • Office visit copay and annual maximums changed from 2022 and vary by plan.
  • Expanded market with plans available in 34 counties, up from 29 in 2022. The new counties added in 2023 are Bon Homme, Day, Jerauld, Marshall, and Roberts.
  • Diagnostic and preventive don't count toward the annual maximum.

Wellmark plans summary

Video overview (2022)

Representatives from DDSD and Wellmark hosted an online webinar (6/28/22) for dental office staff to learn more about Medicare Advantage and the Blue Medicare Advantage plans.  

While plan details have changed for the 2023 plan year, the webinar offers good basic information about Medicare Advantage and including dental benefits from Delta Dental of South Dakota.

Frequently asked questions - Wellmark plans

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The ID card issued by Wellmark Blue Cross Blue Shield will include a L5I or L5J prefix to the enrollee ID, and include the word 'dental' in the bottom left corner of the ID card.

Special note: When submitting a dental claim, DO NOT include the L5I or L5J prefix for the enrollee ID. Use only the identifier that begins with "W" (e.g. W12345678).

 

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Wellmark Blue Cross Blue Shield has four Medicare Advantage plans:

  • Blue Medicare Advantage PPO
  • Blue Medicare Advantage Enhanced PPO
  • Blue Medicare Advantage Valor PPO (new in 2023)
  • Blue Medicare Advantage PPO | Avera (new in 2023)

The name of the plan is identified on the upper right-hand corner of the patient’s ID card.

No, there is no deductible on Wellmark Medicare Advantage plans. Office visit co-pays vary by plan.

They can be done any time in the benefit year.  

The copay goes towards the patient’s portion of the service. The below example is for a service covered at 50%

  • Allowed Amount $258
  • Office Visit Fee $35
  • Plan Payment $111.50
    50% of $223 (allowed amount – office visit fee)
  • Patient Payment $146.50
    (50% of $223 ($111.50) + office visit fee $35) 

Sanford Health

Four Medicare Advantage plans from Sanford Health offer dental benefits administered by Delta Dental in 2023.

  • Two plans by Align powered by Sanford Health Plan called ChoicePlus and ChoiceElite cover preventive care and offer comprehensive care. These plans are available in 19 South Dakota counties, mostly along the I-29 corridor.
  • Two specialized plans by Great Plains Medicare Advantage offer preventive care and denture benefits for those in nursing facilities. These plans are available in 17 South Dakota counties where there are participating good Samaritan nursing facilities.

Sandford plan summaries

Frequently asked questions - Sanford plans

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Sanford has four Medicare Advantage plans:

  • Align ChoiceElite PPO
  • Align ChoicePlus PPO
  • Great Plains Medicare Advantage HMO I-SNP
  • Great Plains Medicare Advantage Gold HMO I-SNP

The name of the plan is identified on the top of the patient's ID card.

I-SNP stands for Institutional Special Needs Plan. I-SNP plans are for patients who reside in a skilled nursing facility and are expected to continue to need institutionalized care for 90 days or longer.

They can be done any time in the benefit year.  

There is no deductible on Sanford Medicare Advantage plans.