Ameritas PrimeStar Care Complete: What Medicare Agents Should Know About This Dental and Hearing Plan
Guest post by Jackson Taylor.
Ameritas PrimeStar Care Complete is an individual dental insurance policy with a hearing benefit built in. It is not a Medicare plan, and it is not Medigap.
That matters because the gap is real. Medicare.gov says Original Medicare doesn't cover most dental services, like cleanings, fillings, extractions, dentures or implants, and doesn't cover hearing aids or the exams to fit them. Medigap plans generally don't cover dental care, hearing aids or glasses either.
Here is what Ameritas publishes about it, how it fits next to MA and Medigap, and what changes by state. Product facts come from Ameritas's public materials, linked below.
Where Care Complete sits in the PrimeStar lineup
PrimeStar is the Ameritas individual dental and vision line. The PrimeStar dental plan sheet (GR 8228 MAC, effective April 1, 2026) shows three dental plans:
Care Lite: the entry plan, with no hearing or implant benefit.
Care Boost: a family plan with child orthodontia.
Care Complete: a "robust plan with hearing benefits for mature individuals," in Ameritas's words.
A few basics from the PrimeStar product handbook (GR 7708, for producers only) and the plan sheet:
Who can buy it: individuals 18 and older and their dependents, with coverage as soon as the next day.
Pricing: set by location, not age. Premiums vary by ZIP area.
Rate guarantee: the producer rate book (GR 7792, effective September 1, 2026) says the monthly premium is guaranteed for the first 12 months and may increase after that.
Issuer: Ameritas Life Insurance Corp., or Ameritas Life Insurance Corp. of New York in New York, per the carrier's disclaimer page.
Not sold in Massachusetts. The handbook says no PrimeStar dental plans are available there.
The dental benefit: day one vs. after year one
Care Complete is built to step up. Here is the base plan sheet, which covers most states:
Annual maximum (Basic and Major combined): $2,000 per person on day one, $3,500 after year one.
Preventive Plus: covered preventive care is not deducted from the annual maximum.
Deductible: $0 for preventive, $50 per person for Basic and Major.
Preventive (exams, cleanings, bitewing X-rays): 100% in network, 80% out of network.
Basic (fillings, simple extractions): 80% in network on day one, 90% after year one.
Major (panoramic X-rays, oral surgery, root canals, periodontics, crowns, bridges, dentures, implants): 20% in network on day one, 50% after year one.
Implants: $1,000 per person per benefit year on day one, $1,500 after year one, and implant payments count against the annual maximum.
No waiting periods on the base sheet. Coverage levels rise after one year on the plan instead.
Here is the napkin math, as a hypothetical. A client needs a crown, and the in-network fee is $1,200. Leaving the $50 deductible aside, Care Complete pays 20% on day one, or $240. After one year on the plan, it pays 50%, or $600.
That is the honest framing. In year one, this is a strong preventive and basic plan with a modest major benefit that grows if the client stays.
The hearing benefit
This is why Care Complete fits a Medicare-age conversation. From the plan sheet:
Hearing aids: the plan pays 50% of the hearing aid cost, up to $200 per ear on day one and $400 per ear after year one.
Hearing exam: up to $75 per year.
Separate bucket: the hearing aid maximum is separate from the dental maximum.
Replacement cycle: full benefit again five years after use, or a reduced benefit after three years if hearing has worsened beyond what the current aids can correct, assuming no break in coverage.
No network required: the PrimeStar agent trifold says hearing benefits are not tied to a network.
Napkin math again, hypothetical. A pair of hearing aids costs $4,000, or $2,000 per ear. Half of that is $1,000 per ear, but the cap controls. On day one, the plan pays $200 per ear, or $400 for the pair. After year one, it pays $400 per ear, or $800 for the pair.
It helps. It does not buy the hearing aids. Say so before the client is at the audiologist's counter.
The rate book's hearing exclusions include medical or surgical ear treatment such as cochlear implants, assistive devices not on the policy's schedule, and services from anyone other than a licensed provider such as an audiologist or ENT.
The rules that shape the claim experience
These limitations are worth covering up front.
Missing tooth clause. The carrier's agent webinar FAQ (GR 8175) says Ameritas will not cover a space where a tooth was removed before coverage started, unless a prosthetic has been in that space at least five years. The rate book words it as no benefit for a first prosthesis unless the extraction happened while covered.
Five-year replacement rule. No benefit to replace crowns, inlays, onlays, veneers or dentures within five years of the last placement, unless an accidental injury while covered requires it.
Work already in progress. No benefit for a procedure begun before coverage started.
Least expensive alternative. When two or more procedures are acceptable treatment, the covered expense equals the least expensive one.
Out-of-network billing. On the base sheet, out-of-network claims are allowed at the lowest network contracted fee in the ZIP Code. The client pays the rest of the dentist's charge.
My advice: ask the client about missing teeth and any treatment plan already in motion before you quote. Those two questions set the right expectations.
Prior coverage, MA dental and stacking
Credit for prior coverage. The CPC brochure (GR 7892) says clients replacing a fully insured dental plan may get year-two coinsurance on day one. Prior coverage must have lasted at least 12 months, with a gap of no more than two months (the handbook says 60 days), and the client gives the prior carrier and policy number at enrollment. CPC does not raise the day-one maximum or the hearing benefit, and it is not available in all states.
The webinar FAQ says a Medicare Advantage plan with dental benefits counts as a fully insured dental plan for CPC, as long as the other requirements are met. That helps a client moving from MA to Original Medicare and Medigap, covered in our MA plan exits and GI Medigap guide. Leaving MA means leaving its dental benefit too.
No coordination of benefits. The same FAQ says PrimeStar plans have no COB provision, so Ameritas processes claims as primary and ignores other EOBs. A client can hold it alongside other dental coverage. Read the other plan's rules before explaining how the two work together.
State differences that change the answer
Ameritas publishes separate state sheets on its agent marketing site. The numbers above come from the base sheet, which lists AL, AR, AZ, CA, CO, DC, DE, HI, IA, ID, IN, KS, KY, ME, MI, MN, NC, ND, NE, NH, NV, OK, OR, PA, SC, SD, TN, UT, VT, WV and WY (except excluded ZIP Codes). Key differences:
New Hampshire: the base sheet says the hearing benefit is not available.
Connecticut, Illinois and New Jersey: the CT, IL, NJ sheet shows a $750 day-one maximum (rising to $3,500), Major at 50% from day one, and implants at $750 on day one and $1,500 after year one.
New York: the New York sheet shows no hearing benefit for Care Complete and a $750 day-one maximum. The rate book's New York limitations include a 12-month pre-existing condition exclusion that prior coverage can shorten.
Ohio and Virginia: the OH, VA sheet (effective September 1, 2026) calls the plan PrimeStar Complete, with a $2,500 day-one maximum rising to $3,000. The hearing benefit is not available in Virginia.
Alaska, Georgia, Louisiana, Missouri and Mississippi: the AK, GA, LA, MO, MS sheet uses the same percentages in and out of network, adds a separate out-of-network maximum ($1,000 day one, $1,750 after year one) and pays out-of-network claims at the 80th percentile of usual and customary charges.
Maryland: three cleanings are available.
Washington: a different plan lineup, with no Care Complete.
Florida, Texas and Wisconsin, and restricted ZIP Codes in Montana, Rhode Island and Wyoming, have their own sheets with the same in-network Care Complete numbers.
Pull the state sheet and quote by ZIP Code before you present anything.
Fitting it next to MA and Medigap
Medigap clients. This is the cleanest fit. Their Medigap plan generally does nothing for dental or hearing aids, so the whole benefit fills a gap. For more on building that conversation, see our ancillary insurance guide for Medicare clients.
MA clients. Medicare.gov notes that some MA plans offer dental, vision and hearing extras. Start with the client's Evidence of Coverage and compare the plan's dental maximum, network and hearing allowance to what the client actually needs. Sometimes the MA benefit is enough. Sometimes it isn't.
Compliance. If dental or hearing comes up in an MA or Part D appointment, scope matters. Under 42 CFR 422.2264, a marketing appointment may not cover health care related products beyond the scope the beneficiary agreed to. Put the product type on the Scope of Appointment or get a separate one, as our SOA, TPMO and call recording guide explains. Never present a dental policy as part of a Medicare plan.
What to verify before you quote
The state sheet for the client's state and ZIP Code, including whether hearing is included.
Missing teeth and work in progress, against the missing tooth clause and the begun-before-coverage exclusion.
Prior dental coverage, including MA dental, for CPC: carrier, policy number, 12 months, gap.
The certificate of coverage, which Ameritas calls the governing document for limitations and frequencies.
FAQ
Is Ameritas PrimeStar Care Complete a Medicare plan?
No. It is an individual dental policy with a hearing benefit. It is not Medigap or Medicare Advantage.
Does PrimeStar Care Complete have waiting periods?
The base plan sheet lists none. Coverage levels and maximums rise after one year instead. New York limitations include a 12-month pre-existing condition exclusion, so check the state sheet.
How much does Care Complete pay toward hearing aids?
On the base sheet, 50% of the cost up to $200 per ear on day one and $400 per ear after year one, plus up to $75 a year for a hearing exam. The hearing benefit is not available in New Hampshire or Virginia, and the New York sheet shows no hearing benefit.
Can a client with MA dental benefits get credit for prior coverage?
Per the carrier's agent FAQ, yes, if the other CPC requirements are met, including 12 months of prior coverage and a short gap.
The Bottom Line
Care Complete is not a Medicare plan. It is a dental policy that rewards staying.
Know the day-one numbers. Know the year-two numbers. Ask about missing teeth. Pull the state sheet.
If you want help building a compliant dental, vision and hearing conversation alongside your Medicare book, book a call with Brock or join one of our weekly agent webinars.
Product details are from Ameritas PrimeStar plan sheets GR 8228 and GR 8085, handbook GR 7708, rate book GR 7792, agent FAQ GR 8175 and CPC brochure GR 7892, reviewed October 20, 2026. Benefits and availability vary by state. Always confirm in current carrier materials.
