Medicare Advantage dental benefits in Sun City (Seniors 65+)

What Forms of Dental Insurance Options Are Available for Seniors?

Medical benefits offered by Medicare are offered to adults who are permanently disabled, adults diagnosed with a chronic kidney disease, and adults who are permanently disabled. People automatically become eligible for Medicare once they turn 65 years old. However, most people are likely unaware that traditional Medicare won't cover the costs associated with basic dental care, which includes professional exams, cleanings, fillings, extractions, or dentures. This can cause Medicare beneficiaries to look elsewhere for assistance in paying for dental services. Thankfully, there are numerous options available, such as a discount plan, in-office financing, private insurance, or enrolling in a Medicare Advantage plan. You can also call our office and speak to our friendly team about dental benefits in Sun City.

Are you wondering what you’ll be expected to pay without insurance or dental benefits? Although prices will vary based on the dental services you need, take a look at the following list to learn more about your potential costs.

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.

What Are Medicare Advantage Plans?

A Medicare Advantage plan is an elective plan that Medicare recipients buy to receive additional benefits that traditional Medicare doesn't provide. Private companies, such as Humana, UHC, and Aetna, offer these optional plans. Beneficiaries of these plans can also receive coverage for prescription drugs and hearing, vision, and dental benefits.

When you choose a Medicare Advantage plan, you can choose from a selected list of network healthcare providers. These supplemental plans also offer additional benefits regarding cost-sharing and price protection measures, such as low deductibles and premiums and restrictions of out-of-pocket spending. Unlike standard Medicare, in which medical professionals receive reimbursement by the government, private companies directly reimburse the provider.

Since supplemental plans are an alternative to Medicare, members will get a different ID card from their insurance company. This card is used in addition to the ID card issued by traditional Medicare. Medicare supplement plans are typically low in cost, making them a good fit for a variety of budgets. It's important to note that dental coverage of supplemental plans is usually limited to cleanings, x-rays, and exams. According to research performed by the Centers for Medicare and Medicaid Services, the monthly cost of Medicare Advantage plans in 2019 is about $28.00.

Can I Benefit from Standalone Dental Insurance?

Standalone dental insurance is a private insurance plan that offers coverage for many different procedures and dental services. Most providers offer different plan levels so you can personalize your coverage based on your unique needs and budget.

Basic Plans:

A basic plan is the cheapest standalone plan available and typically only covers prophylactic and maintenance services, such as exams, cleanings, and x-rays. This plan is recommended for people in good oral health, but you can expect to have significant out-of-pocket costs if you require advanced dental work.

Mid-level Plans:

A mid-level plan provides a mixture of services to meet the needs of most patients. In addition to providing additional benefits for more advanced dental services, including specialized x-rays, dentures, orthodontic treatment, fillings, inhalation anesthesia, and emergency treatment, a mid-level plan also covers the same basic and preventative services as a basic-level plan.

Premium Plans:

A premium plan is considered a top-tier plan and is more expensive as a result. The plan provides coverage for advanced and complex services, such as

• Oral surgery
• Dental restoration services, including inlays and onlays
• Crowns
• Treatment for gum disease, such as endodontic and periodontal procedures
• Complete or partial dentures

The majority of standalone plans cover a specific percentage of the cost that is based on the level of the service you receive. This is typically referred to as "100-80-50." For instance, most standalone plans cover 100% of the cost for cleanings and exams. They also usually pay 80% for most standard services, such as fillings, and 50% of more advanced services.

The costs associated with monthly or annual premiums depend on which type of standalone plan you choose. Seniors might want to consider that while standalone plans usually have more to provide in terms of coverage, these plans exclude benefits for hearing, prescription medication, or vision.

Are There Alternatives to Insurance for Affordable Dental Services?

While they're not considered insurance, dental discount plans are offered by private companies. Instead of paying a monthly or yearly premium, members of a discount plan pay an initial enrollment fee and a small monthly fee. In return, members can take advantage of discounted rates at participating dental offices. Although discount plans usually don't provide the same amount of coverage as insurance, they can significantly lower the cost associated with basic dental services, including:

• Cleanings
• Checkups
• X-rays
• Fillings
• Extractions
• Root canals
• Dentures
• Crowns

Most discount plans are affordable and offer several advantages in comparison to traditional insurance:

• You're able to change providers at any time.
• There isn't a waiting period, so your benefits are immediately available.
• There aren't any copays or deductibles.
• There aren't any limits on how often you use your benefits throughout the year.
• Most people are accepted regardless of age or pre-existing conditions.

Despite these advantages, discount plans are not appropriate for everyone. They're an ideal money-saving option for people already in good oral health, but if you need advanced dental work, a comprehensive insurance plan may save you more money in the long-term.

How Can I Manage Out-of-pocket Dental Expenses?

If you don't have dental benefits in Sun City or have out-of-pocket expenses to pay that aren't covered by insurance, your dental practice may have financing options or payment plans to help spread out the total cost of care. Patients can also apply for CareCredit, a popular financing option that's accepted by more than 200,000 healthcare providers across the nation. CareCredit is comparable to a credit card and allows qualified applicants to make convenient payments each month.

Whether you need long-term or short-term financing, most medical credit companies offer financing options that allow qualified applicants to make payments over a period of two to five years. For some financing companies, if you pay your entire balance in full before the end of your promotional period, no interest is charged. There are some potential drawbacks to financing, however, including an approval process involving checking credit history. With interest rates ranging from 15% to 20%, your total cost of care can significantly increase.

The American Association of Retired Persons (AARP) and other organizations for seniors can provide information about insurance and managing out-of-pocket expenses for dental services. If you have questions about financing options for seniors, please call our office to learn more.