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Many seniors over the age of 65 find that they are in need of dental coverage due to the loss of their employer provided coverage after they have retired. This is because most people in America receive insurance coverage through their employer. Once a senior has left the workforce, he or she is forced to look for different options. This means that around 65% of seniors wind up going without any kind of dental coverage. The number of seniors going without this essential form of medical coverage will only grow since there are over 10,000 Americans who turn 65 each day.
In 2016, seniors spent over $28 billion on dental procedures. Even more telling, seniors were the population with the highest dental expenditures within the United States. The American Dental Association Health Policy Institute found that 6 million more seniors saw a dentist in 2016 than in 2006. This high rate of growth is expected to continue. Even though seniors have seen growing dental care expenses, the Kaiser Family Foundation discovered that almost half of all Medicare users hadn’t seen a dentist within the past year. The same study also found that the 19% who did see a dentist wound up spending more than $1,000 out of pocket. Below are examples of what common dental services cost:
Checkups and Cleanings:
- Basic exam–$50 to $100
- Dental X-ray–$20 to $250
- Standard cleaning–$70 to $200
- Silver amalgam–$50 to $300
- Composite–$90 to $450
- Simple extraction–$75 to $450
- Surgical extraction–$150 to $650
- Wisdom tooth extraction–$75 to $3,000 based on the number and complexity of the extractions
The cost of a crown can range from $500 to $3,000 based on the type of material used.
The cost of a root canal can range from $300 to $2,000 based on the location of the tooth and the complexity of the procedure.
What Dental Insurance Options Are Available to Seniors?
If you are an adult over the age of 65 or are considered to be permanently disabled, you are entitled to receive Medicare coverage for your medical expenses. You are automatically enrolled in Medicare when you turn 65. When this happens, you will be sent your red, white and blue identification card for Medicare. However, traditional Medicare does not provide dental benefits in Suwanee for routine dental procedures such as cleanings, fillings and extractions. If you are having another type of procedure that is covered by Medicare that requires these basic dental services, then your dental procedure may be covered under the Part A hospital benefits section of Medicare. An example of this would be if you need a basic oral exam before you can be cleared for surgery. Because of this lack of basic dental coverage, many Medicare beneficiaries must look for a different way to pay for their dental care. In fact, 10% of seniors wind up purchasing policies from private dental insurers, while another 25% sign up for Medicare Advantage plans.
How Do Medicare Advantage Plans Work?
A Medicare Advantage plan is an optional supplement that you can buy in order to expand on the number of dental benefits in Suwanee provided by traditional Medicare. This type of supplemental plan will allow to have access to a network of approved providers while also giving you price protection through out-of-pocket spending limitations, cost-sharing measures and low deductibles. While traditional Medicare plans consist of the government reimbursing medical care providers, the benefits provided to you via a supplemental Medicare plan consist of the dental insurer reimbursing medical care providers.
You can purchase a Medicare Advantage plan from insurance companies such as Humana, UHC and Aetna. Many of these types of plans also provide you with some kind of vision and prescription drug coverage. If you choose to enroll in this kind of plan, you will most likely receive a card from your insurer. These kinds of plans generally have lower premiums and are exceptionally affordable for seniors. The plans are usually limited to basic examinations, standard X-rays and dental cleanings. The average premium that seniors paid for one of these plans in 2018 was $420 per year.
What Do I Need to Know About Standalone Dental Insurance?
If you are in need of more comprehensive types of dental coverage, purchasing standalone dental insurance may be the right option for you to pursue. A number of insurance companies provide their customers with a number of different levels of coverage at different prices. The premiums you will be expected to pay, along with the amount of costs covered and the kinds of services included will vary depending on what kind of plan you choose.
A basic dental insurance plan usually consists of coverage for cleanings, oral examinations, diagnostic X-rays. Other types of prophylactic services are usually included with these types of plans.
Coverage for orthodontics, specialized X-rays, dentures, fillings, inhalation anesthesia and emergency treatments are usually provided with mid-level plans.
A premium plan will typically provide you with partial coverage (and perhaps more) for advanced procedures. These types of plans are perfect for those seniors who have a number of dental health care needs. Some examples of what may be included with a premium plan include:
- Inlays and onlays
- Oral surgery
- Complete and partial dentures
The vast majority of private insurance plans provide “100-80-50” tiered coverage. Routine exams are usually 100% covered, while fillings and other basic services are covered at 80%. More complicated services, such as a dental crown, are usually covered at 50%. While private insurance rates tend to be cheaper than supplemental Medicare plans, you will not have access to vision, hearing and prescription drug benefits like you would with a Medical supplemental plan.
What Do I Need to Know About Dental Discount Plans?
Another way to lower the amount of your dental expenses is to enroll in a dental discount plan. While these types of plans are offered for purchase by private companies, they are not considered to be insurance. Dentists who accept these plans have come to an agreement with the provider to accept a discounted rate for services. Rather than pay an annual or monthly premium, the customer pays an enrollment and monthly membership fee to the provider. The patient will then pay the dentist directly at the agreed upon discounted rate.
A dental discount plan is usually pretty affordable. They also offer you several advantages that insurance plans do not. These include:
- No deductibles, copays or coinsurance.
- No waiting periods for benefits.
- No limits on the number of visits you can make to the dentist.
- No prohibition on changing your dentist.
- No age limits or pre-existing condition limitations.
- No claim forms or paperwork to fill out.
While a dental discount plan won’t provide you with the same amount of coverage that traditional insurance will, your costs may be significantly lower for procedures like:
- Root canals
There are a number of popular discount plans that also provide you with discounts for vision services, hearing services and prescriptions. DentRite® is one of these discount plans. If you are in good oral health and only require regular cleanings and maintenance visits, a dental discount plan may be a good option for you to pursue. However, purchasing an insurance plan may be a better option if you require a lot of dental work.
Can You Tell Me About the Options Available to Me to Manage My Larger Dental Expenses?
Many seniors in search of dental benefits in Suwanee are also concerned about the affordability of their dental health care. A number of dentists provide payment options and other types of financing options to their patients. CareCredit is an exceptionally popular financing option. It is accepted by over 200,000 health and wellness providers across the United States. Most credit companies providing financing for medical expenses provide patients with short-term financing of 24 to 60 months. Financing through medical credit companies comes with a number of downsides. These include:
- A requirement that the patient goes through an application and approval process, meaning that not everybody will qualify for the financing option.
- High interest rates of 15% to 20%.
If you would like more information about affordable dental care and where you can receive discounts on dental services and insurance, contact your local senior organizations like AARP. Feel free to call our office if you would like to schedule an appointment or learn more about dental benefits in Suwanee.