Medicare Advantage is designed to cover medical needs like hospital stays, doctor visits, and prescriptions. It was never designed to cover everything. A crown or an implant can still leave your client with a significant out-of-pocket expense. The same is true with ACA plans, where adult dental coverage typically isn't included.

That doesn't make the core plan a bad plan. It just means there are needs it wasn't built to cover. And that's where ancillary products come in.

The problem is, your client may not know where those gaps are. They may assume they're covered until they're sitting at the dentist and find out otherwise. By then, you've missed the opportunity to help them plan for that expense.

That's why identifying gaps should be part of every client conversation. You know what their primary plan covers, what it doesn't, and where they could be left paying out of pocket.

Make sure your clients understand what is and isn't covered, and help them fill the gaps.

Most agents finish presenting the core plan and then bring up dental. By then, it can feel like an add-on.

Instead, expose the gap before you present the core plan. Tell the client you've found a plan that fits their needs, but before you walk through it, make sure they understand what it doesn't cover, or where the coverage is limited. Let them know you'll come back to that gap after you've gone through the plan.

Why the order matters:

• You're pointing out the limitation before you're trying to sell the solution. That makes it part of explaining their coverage, not an upsell at the end.
• The client already knows there's a gap. When you come back to dental later, you're addressing something you've already discussed, not introducing a new need.
• It builds trust. You're willing to point out what the core plan doesn't do, even while you're recommending it.

The sequence is simple: expose the gap → present the core plan → come back and fill the gap.

The core plan changes. The framework doesn't. Find where the coverage falls short, make sure your client sees it, then fill the gap.

• Selling Medicare Advantage? Don't assume an embedded dental benefit means your client is covered. Those benefits are getting smaller, and what remains can come with limited networks, restrictions, or benefits that are difficult to use. When an embedded dental benefit doesn't live up to the client's expectations, it doesn't just create frustration with the dental benefit. It can jeopardize their satisfaction with the core plan you worked to put in place.
• Selling Medigap? The gap is clear. Original Medicare doesn't cover routine dental care, and a Medigap plan doesn't change that. Without separate dental coverage, the client is paying those expenses out of pocket.
• Selling ACA? Adult dental isn't an essential health benefit. If it isn't included, your client needs a separate solution for dental coverage.

Different core plans create different gaps. Your job is to know where they are, make sure your client understands them, and confidently present a solution.