Medicare Advantage Dental Benefits in South Hampton Roads

Where Can Seniors Find Dental Insurance?

Individuals 65 or older typically have Medicare, a health insurance program offered by the federal government. Some disabled people who receive Social Security Disability Insurance also qualify for Medicare, although, most Medicare beneficiaries are senior citizens. Original Medicare (Parts A & B) cover inpatient and outpatient health care, but it does not cover dental care except if it’s medically necessary. Medically necessary is limited to only what is essential for a person to receive medical treatment. For example, Medicare may pay to have a broken tooth extracted before major surgery, however, they won’t cover the cost of replacing the tooth. Part D covers prescription drug costs. Most people don’t pay for Medicare Part A.

Seniors need to take care of their oral health. Common problems include dry mouth from medications which can cause cavities, including root cavities, and gums naturally recede as people age. Additionally, people over age 65 with missing teeth in their mouth are less likely to eat a balanced diet and socialize with others, affecting their quality of life. Considering that senior citizens spent over $28 billion on dental services in 2016, and 6 million more saw the dentist in 2016 than in 2006, it’s important to senior citizens to be able to get affordable dental care.

While nearly all senior Americans have medical insurance thanks to Medicare, about 35 percent of Americans don’t have dental insurance. Many of these are seniors who lost their employer-sponsored coverage when they left the workforce. Senior citizens can select Medicare Advantage, standalone dental insurance or a dental discount plan to have dental benefits in South Hampton Roads.

Checkups and Cleanings:

  • Basic exam–$50 to $100
  • Dental X-ray–$20 to $250
  • Standard cleaning–$70 to $200

Fillings:

  • Silver amalgam–$50 to $300
  • Composite–$90 to $450

Extractions:

  • 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

Crowns:

The cost of a crown can range from $500 to $3,000 based on the type of material used.

Root Canals:

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 Medicare Advantage Plans Offer Dental Benefits?

When you become Medicare-eligible, you have crucial decisions to make, including whether you need additional coverage beyond what Original Medicare offers. Medicare Advantage plans, also known as Medicare Part C, offer Medicare Part A and Part B coverage plus they may offer more benefits, such as vision or dental. Medicare-approved private insurers sell health maintenance, preferred provider and fee-for-service plans. Anyone who receives Medicare Parts A and B is eligible to sign up for an Medicare Advantage plan if the plan services their location.

According to AARP, one in three retirees choose an Medicare Advantage plan instead of Original Medicare. This number is expected to grow. Many of the larger companies, like Humana and Aetna, offer all three types of plans. Where people live greatly affects the number of Medicare Advantage plans available to them with supplemental benefits. One in five seniors with Medicare Advantage plans have group plans which their former employer or their union uses for their retirees according to the Kaiser Family Foundation. Many unions, employers and state governments use Medicare Advantage plans to keep a handle of health care costs for retirees.

While most Medicare Advantage policies offer preventative care benefits only, some offer more comprehensive coverage. Seniors have special dental needs. If possible, they should find a plan which will cover tooth repair services, a common problem for people over age 65. Other common problems include gum disease and painful dentures which don’t fit correctly anymore.

Will Standalone Dental Insurance Save Seniors Money?

When senior citizens leave the workforce, they often leave behind employer-sponsored dental insurance. Seniors can purchase dedicated insurance to help with dental costs and provide dental benefits in South Hampton Roads. While insurance has its limitations, the right plan can help seniors save money. As private companies sell the plans, coverage, deductibles and copays will vary.

Typical coverage follows the 100-80-50 principle. Preventative care is usually 90 to 100 percent covered. Fillings and other basic restorations are typically 80 percent covered and major restorations, like dentures, are 50 percent covered.

Major insurers typically offer preferred provider organization (PPO) plans and/or health management organization (HMO) plans. PPO plans allow you more freedom to choose a dentist while HMO plans have a specific network of dentists and you must one one to get coverage. HMO plans tend to be more affordable. Top insurers include Delta Dental, Humana and UnitedHealthcare.

Seniors who don’t need a lot of work may end up saving money by paying out-of-pocket expenses or purchasing a discount dental plan. Individuals who are likely to need extensive dental work can save money by buying insurance as long as the annual benefit limit isn’t too low and there isn’t a long waiting period for the work they will likely need. Waiting too long for treatment can cause a dental problem to become worse and more painful. Veterans can often buy insurance at a reduced rate.

Group insurance is usually a bargain. Seniors who still belong to professional organizations or trade associations should inquire about group plan availability. Group plans often accept everyone and offer more benefits than a person could get with individual insurance. Insurance companies count on some group members to hardly use their benefits which makes up for others who use their maximum benefits.

How Do Dental Discount Plans Differ from Insurance?

With discount dental plans, a person joins a plan and pays an enrollment and an annual or monthly fee. In return you can visit participating dental offices and receive services at a discounted rate by showing a membership card. Full coverage will start when a person receives their membership card in the mail. With plans like DentRite®, you may also receive discounted vision and hearing care. Since discount dental plans are not insurance, seniors will enjoy these advantages:

  • No age limitations – everyone is approved
  • There’s no waiting period for major work
  • There are no pre-existing condition exclusions
  • No paperwork or claim forms
  • There’s no limit to the savings each year

Typical dental benefits in South Hampton Roads, discounted for plan members include:

  • Preventative care, including exams, x-rays and cleanings
  • Basic restorative care, including fillings, extractions and root canals
  • Major restorative care, including crowns and bridges
  • Some discount dental plans also offer savings on cosmetic work.

What Is the Easiest Way for Seniors to Handle Unexpected Dental Expenses?

Ask the staff at your dental office about financing and payment plans. You can also ask your dentist if there is an alternate, less expensive treatment option. CareCredit is a popular way to obtain short-term financing for medical and dental costs. If you’re approved, there are promotional periods where you pay no interest for several months. If you cannot pay the balance during the promotional period, interest rates apply. Seniors can also find their own 0 percent interest credit card if their credit is good. Many cards have promotion offers which can help finance dental procedures which cannot wait.

For retirement-age individuals on a fixed income, out-of-pocket dental care expenses can be prohibitive. Organizations for retired persons, such as AARP, also have information about how to handle out-of-pocket expenses.

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