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What Can Seniors Do for Dental Insurance?
Senior citizens age 65 and over and certain disabled individuals who receive Social Security Disability Insurance (SSDI) benefits qualify for Medicare, the medical insurance offered by the federal government since 1966. The Centers for Medicare and Medicaid Services administer the program which was once part of Social Security. You’ll be automatically enrolled in Original Medicare (Parts A & B) when you turn 65 and begin receiving Social Security. Original Medicare helps cover the costs of staying in the hospital and doctor visits, but you will still have out-of-pocket costs. It does not have dental coverage, except if you need a medically necessary dental procedure. Rare medically necessary care may include an exam before an organ transplant or other serious medical procedure. Medicare’s extremely limited dental coverage does not count as insurance for senior citizens.
Seniors can sign up for Medicare Part C, which is Medicare Advantage offered by private companies approved by Medicare. These companies combine Medicare Parts A & B, plus they often offer additional benefits, including dental, vision and hearing benefits. Senior citizens can look for standalone dental insurance which isn’t part of a health insurance policy. Discount dental plans can also offer dental benefits in Dunwoody even though they are not insurance.
Does Medicare Advantage Offer Dental Benefits in Dunwoody?
Any Original Medicare (Part A and Part B) beneficiary is eligible to enroll in a Medicare Advantage (Part C) plan. This includes anyone who receives Medicare because of a disability. According to AARP, one third of Medicare eligible individuals choose an Medicare Advantage plan. Most hospitals and doctors accept Medicare, but individuals in Medicare Advantage plans have more limited options. Many senior citizens join plans for the extra benefits, such as dental and other supplemental coverage. About 7 out of 10 plans have some type of hearing or dental coverage. New rules allow insurance companies to offer podiatry care for individuals with diabetes and non-medical benefits such as meal deliveries. The trade off for these supplemental benefits is a more limited choice of providers and possibly higher premiums. According to MedicareAdvantage, 45 percent of plans have no monthly premium.
Medicare Advantage plans vary and they may not include extra benefits. Dental benefits can span from preventive care coverage to coverage for fillings, extractions and treatment for gum disease. Aetna, Humana and UHC are among the popular plans seniors select. Plans vary in cost and benefits. They typically only offer limited dental benefits in Dunwoody, such as coverage for preventative care only or they may limit treatments, such as one root canal a year.
What Is Standalone Dental Insurance?
It is dental insurance offered by itself, not as part of a health insurance plan. Insurance will pay some of your costs when you visit a dentist. You’ll pay a monthly premium and your dental fees until you’ve paid the specified deductible. Afterward, you’ll pay coinsurance, or your percentage of the payment. Some dental plans use a copayment system instead, which is where you have to pay a fixed cost, instead of a percentage, for a service. There are Preferred Provider Organization plans, which are good for seniors as they offer more coverage than Health Maintenance Organization plans which are more affordable, but typically offer less coverage.
Basic insurance plans will cover preventative care, such as routine exams, x-rays and professional teeth cleanings. Mid-range plans will also partially cover fillings, root canals and other services. Premium plans will cover all these items plus crowns, bridges and dentures. It’s rare for dental insurance to cover cosmetic procedures. Insurance is good for seniors if their teeth are still in good shape because it encourages preventative care.
Many insurance policies will only pay $1000 to $2,000 a year in benefits. For people with good dental health, this is usually adequate. Individuals with poor dental health can exceed this cap easily with dentures or a bridge to replace missing teeth. Most policies also have missing teeth clauses. If you were missing a tooth before buying insurance, the company will not pay to replace the tooth. Seniors might be able to waive coverage for orthodontics and save money.
While seniors may lose their group insurance when they retire, they may still belong to trade or professional organizations or alumni associations which offer insurance at group rates. Group plans cost on average less than individual policies so it pays to investigate all possible sources of group coverage.
Are Dental Discount Plans a Good Way to Manage Dental Expenses?
Private companies sell discount dental plans, which are not insurance. The plans offer dental care by participating providers at a discounted rate. You pay a small enrollment fee and a monthly or annual fee for the plan and then pay the discounted fee when you see a dentist and you show your membership card. Discount dental plans are generally more affordable than insurance.
Discount dental plans offer many advantages over insurance, including:
- No waiting periods
- No annual benefit caps
- Cosmetic procedures may be included
- Everyone is accepted
- No claim forms
- Coverage for pre-existing conditions
Additionally, discount dental plans like DentRite® offer other benefits, such as discounted vision and hearing care. Discount dental plans usually offer the largest savings on preventative care. Seniors who worry about large dental bills should prioritize spending on preventative care. If you occasionally need a filling, it isn’t nearly as expensive as needing an emergency root canal.
Where Can Senior Citizens Get Help with Additional Expenses for Dental Care?
Many dentists accept CareCredit, a health care credit card which you can apply for over the phone. Everyone does not qualify. If you’re approved, there may be a promotion period of promotional financing for six, 12, 18 or 24 months, depending on your credit score, which allows you to pay off the balance without being charged interest. If you use a traditional credit card which begins charging interest immediately, it will increase the total cost you’ll pay for your care. You can use the card at dental offices with CareCredit. Dentists who obtain the certification are ones who can explain their fees and financing accurately to patients. Some dentists also offer payment options and flexible financing.
If you’re a senior citizen, you can contact AARP or another senior organization and ask about discounts for insurance or services. Veterans can also contact the Department of Veterans Affairs to inquire about possible dental benefits. Modern dentistry can help seniors keep their teeth and gums healthy. Fortunately, most senior citizens have options for paying for the care so they can enjoy good dental health throughout their lives.