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Every day, more than 10,000 Americans turn 65 and they’re automatically enrolled in Medicare. These are the people who are frequently most in need of dental insurance, yet they’re the most under-insured demographic in the U.S. Although most of them had dental and medical insurance from their employers, when they retired, they no longer retained their insurance. Now, most of them do without the dental treatments that they need or they’re forced to obtain coverage through other means. About 25% obtain insurance through a Medicare Advantage plan while another 10% obtain dental benefits from private insurance companies. Since the number of seniors increases daily, this statistic will only worsen.
Despite their lack of insurance coverage, in 2016, seniors spent more than $28 billion on dental procedures, and had the highest growth rate in dental spending of any demographic. The American Dental Association reports that in 2016, 6 million more seniors sought dental care than in 2006. A study conducted by the Kaiser Family Foundation reported that half of all Medicare recipients hadn’t sought dental care in the preceding year, and of those who had, almost one-fifth spent more than $1,000 for out-of-pocket dental expenses. The high cost of dental procedures may be the primary reason for the lack of treatment, as the following examples will show.
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.
Do Seniors Have Other Options for Dental Insurance?
Those who are 65 years or older or those who are permanently disabled are eligible for traditional Medicare, but it doesn’t provide coverage for dental treatments unless they’re needed for a surgical procedure. This means that Medicare beneficiaries must obtain their dental coverage from other sources, such as the Medicare Advantage plans that are offered by insurance companies such as Humana, Aetna, and United Health Care. Advantage plans are the most popular and many Medicare beneficiaries select this option.
How Do Medicare Advantage Plans Benefit Seniors?
Traditional Medicare is primarily for hospitalization and provides no additional benefits for prescription drugs, vision or hearing. An Advantage plan provides coverage that expands traditional Medicare’s basic coverage and allows plan members to obtain hearing, vision, and prescription drug benefits. While the government reimburses the provider for traditional Medicare services, under an Advantage plan, the provider is reimbursed by the insurance company. Advantage plan members will receive an ID card that’s separate from their Medicare card, and they’ll benefit from low premiums, affordable deductibles, and cost-sharing measures. However, dental benefits are limited under an Advantage plan and usually cover only annual cleanings, basic examinations, and standard x-rays.
Should I Obtain a Standalone Dental Insurance Policy?
If you need more comprehensive dental coverage, then standalone dental insurance may help you. Coverage options vary according to the premium level, and the more expensive premiums provide the widest spectrum of coverage. Examples of pricing options are as follows:
These types of plans will generally cover annual exams and dental cleanings, and diagnostic x-rays.
These types of plans will provide the basic coverages plus some expanded services such as emergency treatments, dentures, fillings, orthodontic work, specialty x-rays, and inhalation anesthesia.
Premium plans provide the most comprehensive coverages, but their monthly payments are also the highest. They’re the most cost-effective plans for those who require significant dental treatments, and the covered services include the basic and mid-range services, plus:
- Full and partial dentures
- Endodontic procedures
- Onlays and inlays
- Oral surgery
- Periodontal procedures
These types of standalone dental insurance plans usually have a tiered coverage structure, which means that you’ll be responsible for partial payment for many procedures. Usually, the rate is 100-80-50, which means that the cost of routine procedures is 100% covered, the cost of basic procedures is covered at 80%, and the cost of complex procedures is 50% covered. Although this type of coverage is beneficial, you could still be liable for a substantial amount. While this may cost less than a Medicare Advantage plan, it won’t include any hearing, vision or prescription medication benefits that may be included with an Advantage plan.
Will a Discount Dental Plan Help Me Afford My Dental Treatments?
Discount dental plans aren’t insurance plans, but they may help make your dental procedures more affordable. Their coverages may be less than the typical insurance policy, but they can substantially lower the cost of procedures such as:
- Annual exams
- Dental cleanings
- Root canals
Dental discount plans are membership plans. The patient pays an enrollment fee and a monthly membership fee and then pays the provider directly for services that are charged at a preset rate that’s been established between the dentist and the discount provider. These types of plans are very affordable and offer benefits that insurance policies often don’t, such as:
- Very forms to complete at enrollment
- No waiting periods for dental benefits in any area of the country
- No copays, deductibles or coinsurance obligations
- No limits on office appointments
- No exclusions for age or pre-existing conditions
- You can change dentists at any time
Many popular discount dental programs such as DentRite also include savings on vision, hearing, and prescription costs. If you’re in good health and need a basic plan, then this type of coverage may work well for you. If you need extensive dental work, however, a standalone policy may be a more cost-effective option for you.
How Can I Better Manage My Out-of-pocket Expenses?
Many dental offices offer flexible financing and payment options because they know that even with insurance and savings plans, dental treatments can be expensive. CareCredit is a popular medical credit company that’s accepted at more than 200,000 providers throughout the nation, and they usually offer a 24-month, same-as-cash option that is interest-free as long as the balance is paid in full within the specified time. Other options include a 60-month plan, but there are drawbacks to financing your dental treatments. Interest rates are high, they start at 15% and can rise to more than 20%, and the interest charges can add substantially to the overall cost of your procedure. There’s also an application to complete and an approval process, so not every patient will qualify for financing. Some senior organizations, such as AMAC and AARP, provide discounts for professional services, insurance, and other retail purchases, so check out their websites for discounts that can save you more money on your dental procedures.
If you need dental benefits in the Voorhees area, then call Dental Arts of South Jersey at (856) 324-3361 and let us help you. Don’t delay seeking treatment due to financial constraints. Call our office today and we’ll help you maximize your dental benefits in Voorhees. We can get you back on the road to good oral health, so call us today.