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Those who are 65 years or older, even though they are usually the most in need of good dental care, are often those to whom it is the least available. Most Americans receive insurance through their employer, but when they retire, they’re often left with limited medical insurance and no dental insurance. This means that seniors must seek dental insurance through alternative methods, usually from private insurance companies, and as many as 65% of seniors simply go without needed dental care due to a lack of dental benefits in Sweetwater. About 10,000 Americans turn 65 every day, so the number of seniors who lack coverage for needed dental treatment will only increase.
Even though they lack insurance, in 2016 seniors spent more than $28 billion on dental expenses and almost 20% spent more than $1,000 on out-of-pocket costs. Unfortunately, this means that about half of all Medicare recipients don’t go to the dentist annually, according to the Kaiser Family Foundation. The cost of dental procedures is the main reason for seniors neglecting their dental health. The following examples of treatment costs may explain in more detail:
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.
Are There Options for Affordable Dental Benefits in Sweetwater for Seniors?
When a person reaches 65 years of age, they’re automatically enrolled in Medicare Part A, and everyone receives the familiar red, white, and blue ID card. Medicare, however, doesn’t provide coverage for dental, vision or hearing expenses. Those must be obtained through one of the several Advantage plans that are available to seniors. There are also dental discount plans that can expand the benefits for seniors, but they can become costly. About 10% of seniors use a discount dental plan and an additional 25% opt for a Medicare Advantage plan.
What’s a Medicare Advantage Plan?
Medicare Advantage plans provide benefits that are lacking in traditional Medicare. Advantage plans have a network of participating providers, similar to an HMO, that offer services at a lower rate than is available to the general public. They’re attractive to providers because the insurer pays the provider directly, which eliminates the need to wait for government reimbursement. United Healthcare, Aetna, and Humana are some of the largest providers of Medicare Advantage plans and they include vision and prescription drug benefits in addition to their dental benefits. Advantage plan members will receive a separate ID card, and you’ll be responsible for a separate premium for the plan. The providers endeavor to maintain low premiums, and MedicareAdvantage.com reports that the average annual premium for an Advantage plan in 2018 was about $420, which is about $35 monthly.
Is a Standalone Dental Insurance Plan Worthwhile?
Standalone dental insurance plans can provide more comprehensive dental coverage than an Advantage plan, and there are several pricing options available. The amount of the premium will depend on the type of the plan you select, but examples are as follows:
Basic plans generally cover annual checkups, various types of cleanings, and basic x-rays.
A mid-range plan will usually provide more services, including dentures, emergency treatment, fillings, inhalation anesthesia, orthodontics, and specialized x-rays.
Premium plans usually provide the most comprehensive benefits, such as:
- Endodontic procedures
- Full and partial dentures
- Inlays and onlays
- Oral surgery
These services are usually provided as tiered coverage, which means that routine procedures are 100% covered under the plan, basic procedures are covered at 80% of the standard rate, and complex procedures such as crowns are provided at 50% coverage of the standard rate. The patient is responsible for the balance that the plan doesn’t cover.
Is a Discount Dental Plan Better Than Insurance?
Discount dental plans are great adjuncts to insurance, but they may not be suitable for everyone’s dental needs. Under a dental discount plan, the dentist agrees to accept a discount for basic services, and the patient pays an enrollment fee and a small, monthly membership fee. The patient pays the dentist directly at a discounted rate determined by the dental discount plan provider. For those who are in overall good health, a discount plan can be cost-effective, but for those who require extensive dental work, an insurance plan may be better.
Discount dental plans have some advantages that insurance plans lack, such as:
- No exclusions for pre-existing conditions
- No waiting periods to receive full benefits
- No annual limits on office visits
- No limits on changing dentists
- No claim forms or paperwork
- No age limits
Discount plans will usually provide for the following services at a substantially reduced rate:
- Annual exams and checkups
- Extractions and fillings
- Prophylactic procedures
- Root canals
Some discount dental plans such as DentRite and others, offer additional discounts for hearing, prescriptions, and vision. If you’re in good health, a discount dental plan may be right for you. However, for those who need more extensive dental work, an insurance plan may be more cost-effective.
How Do I Manage Out-of-pocket Expenses?
Even with discounted rates and insurance coverage, out-of-pocket expenses can still be costly. Many dental offices provide flexible financing options and payment options, but if yours doesn’t, CareCredit may be able to help you. CareCredit is accepted nationwide by more than 200,000 providers and is a great alternative for high out-of-pocket expenses.
Some senior discount agencies such as AMAC or AARP offer additional benefits to seniors on a variety of services from insurance to professional services, so be sure to check those out.
If you need dental benefits in Sweetwater and haven’t found any that fit your needs, then call Sweetwater at (321) 594-2628 and let us help you. Don’t procrastinate in obtaining the dental benefits that you need, call us today and we can help you regain your good oral health at a rate that fits your budget. We look forward to speaking with you and working with you.