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Taking care of your teeth is important at any age, but it can be difficult to receive the care you need later in life. Seniors over the age of 65 are often those who require dental care most, but they sometimes have the least access to dental benefits in Sarasota. This is typically due to lack of insurance coverage, which is normally provided through employers. Seniors looking for affordable dental benefits must look to other options once they retire, including Medicare supplement plans and discount plans. However, nearly two-thirds of seniors go without dental coverage, and this number is expected to rise over time.
Despite many seniors going without dental insurance, spending on oral health services is increasing overall. Seniors spent more than $28 billion on dentistry last year, and the growth rate of senior spending was higher than all other demographics. In fact, the American Dental Association Health Policy Institute found that 6 million more seniors saw the dentist in 2016 than they did a decade ago. Plus, the number of seniors visiting the dentist is expected to increase over time, as 10,000 people reach age 65 every day in the U.S.
While dental health spending is up overall, a study by the Kaiser Family Foundation revealed that nearly half of seniors receiving Medicare hadn’t visited a dentist in the past year, and 19% of Medicare recipients spent more than $1,000 themselves. The list below outlines some of the typical costs of dental procedures:
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 Choices Do Seniors Have for Dental Insurance?
Seniors have options when it comes to receiving dental benefits in Sarasota. If you’re over the age of 65 or disabled, Medicare is available to cover healthcare needs. Once you reach 65, you are automatically enrolled in Medicare coverage and will receive a red, white, and blue ID card. However, Medicare has some limitations, as it does not provide benefits for routine dental checkups and cleanings as well as common procedures like fillings and tooth extractions. Some dental procedures may be covered by Medicare Part A benefits if they are necessary to complete a covered procedure. This might include a dental exam to clear a patient for surgery.
Medicare’s limitations often leaves seniors looking for other ways to manage dental expenses and expand their coverage. Some may turn to private insurers while 25% will look to Medicare Advantage plans.
What Is a Medicare Advantage Plan?
Medicare Advantage plans supplement your existing Medicare benefits to provide more options and savings on medical costs. These plans allow seniors access to a larger network of healthcare providers and provide price protection through spending limits, lower deductibles and cost-sharing measures. These plans are different from traditional Medicare because all costs are reimbursed by the private insurer, not the government. They often provide benefits for general medical care, but they sometimes offer coverage for dentistry, vision care, and prescriptions as well. Aetna, Humana, and UHC are all popular providers of Medicare supplement plans.
Medicare supplement plans usually have a separate ID card that you’ll present at the time of service. You may receive lower premiums, making these plans an affordable option. Keep in mind that the plan benefits are usually limited to preventive care like X-rays, cleanings and checkups.
Do I Need Standalone Dental Insurance?
If you need more comprehensive dental coverage, a standalone dental plan may be right for you. These are provided by insurance companies and provide several coverage options. Your monthly or yearly premiums, what services are covered, and the percentage of costs covered will depend on what plan you select. Some common types of standalone insurance plans include the following.
Basic plans: With a basic plan, oral exams, tooth cleanings and preventive services are covered. This also includes X-rays and oral cancer screenings.
Mid-level plans: Mid-level plans include expanded services like orthodontic care, emergency dental services, and panoramic X-rays. You may also receive coverage for nitrous oxide, dentures, or fillings.
Premium plans: The top-tier plans provide at least partial coverage for more advanced procedures. This makes them ideal for those requiring extensive dental work. Some services covered by a premium plan are:
- Tooth crowns
- Onlays and inlays
- Endodontic treatment
- Oral surgery
- Complete or partial dentures
- Gum disease treatment
Private dental plans often provide “100-80-50” tiers of coverage. This usually means that routine dental checkups are covered completely, basic dental treatment is covered at 80%, and more complicated treatment is covered at 50%. According to Bankrate, private dental plans for seniors usually cost $350 in premiums annually. While this can be lower in cost than Medicare Advantage premiums, these plans often don’t offer the hearing, prescription and vision benefits.
Can Dental Discount Plans Save You Money?
Much like a standalone dental insurance plan, a dental discount plan is sold by a private company – but it’s important to remember that it is not insurance. Dental offices accepting discount plans agree to accept reduced rates for routine services. Instead of paying regular premiums, discount plan members will pay an enrollment fee and low monthly dues. They’ll also pay the dentist directly at reduced rates instead of filing an insurance claim.
Discount plans are usually very affordable. They also provide several benefits over private insurance plans, including:
- No deductibles, coinsurance requirements, or copays.
- No waiting period before you can receive services.
- You can see the dentist as often as you wish – there are no visit limits.
- You can change dental practices at any time.
- Discount plans require no claims or paperwork, saving you time at the dentist.
- There are no exclusions for preexisting health issues or age limitations.
While discount plans may not offer as much coverage as traditional insurance, they can save you money on routine dental treatment. These services include:
- Routine dental exams and cleanings
- Tooth crowns and fillings
- Root canals
- Restorative treatment, including dentures
DentRite and other well-known discount plans also provide savings on hearing aids, prescriptions and vision care. If you are in generally good dental health and will only need maintenance, a discount plan could be a money-saving option.
What Can I Do to Manage My Own Dental Costs?
Many seniors have concerns about out-of-pocket expenses when receiving dental care, and flexible financing can make these costs more manageable. CareCredit can be an excellent option for qualified patients and is accepted at more than 200,000 providers across the country. Medical credit companies provide long-term financing for larger purchases. However, it’s important to understand the disadvantages of medical credit, including:
- The application and approval process – just with traditional credit lines, not every person will qualify
- Interest rates between 15% to more than 20%, which add to the overall cost of care
We encourage all seniors to explore every option possible when looking for affordable dental benefits in Sarasota. If you have additional questions about your benefits, we recommend reaching out to the AARP or other senior organizations. These groups are a valuable resource for seniors looking for information about their Medicare Advantage options. You can also contact us if you have questions about our services or financing.