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

Even though they aren't usually insured, seniors take their dental care seriously. In 2016, the American Dental Association reported that more than 6 million seniors sought dental care and, in aggregate, spent more than $28 billion for dental treatments. Due to the increasing number of seniors in the population, this number is likely to increase. The Kaiser Family Foundation reports that almost half of all seniors who receive Medicare benefits hadn't had a dental visit within the preceding year. Of those who had, more than 19% spent more than $1,000 on out-of-pocket dental costs. The high cost of dentistry is the main reason for the lack of dental treatment in the senior demographic. The following are examples of typical costs for common dental procedures:

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.

Are There Any Dental Insurance Options for Seniors?

Everyone who turns 65 is automatically enrolled in Medicare Part A. However, Part A doesn't provide coverage for dental procedures unless they're required for a surgical procedure. This means that Medicare beneficiaries must have alternate sources for their dental needs or go without. About 10% of seniors utilize private companies for the insurance and another 25% utilize a Medicare Advantage plan from one of several providers. Aetna, Humana, and United Healthcare are some of the most popular providers of Medicare Advantage plans.

How Do Advantage Plans Help Seniors?

A Medicare Advantage plan expands the benefits offered by traditional Medicare through the use of qualified providers that offer lower rates, lower deductibles, and lower out-of-pocket costs. Under traditional Medicare, the government reimburses the health and dental providers, and it can sometimes take months to receive payment. Those who enroll in an Advantage plan have their qualified expenses paid by the insurer, so it's advantageous to the provider because they are paid more quickly. Those who are enrolled in an Advantage plan will receive an identification card that's separate from the Medicare card. Medicare Advantage plans usually have affordable premiums, but they may have limited dental benefits. MedicareAdvantage.com states that the average 2018 premium for an Advantage plan was about $35 per month or $420 per year.

Is Standalone Dental Insurance a Viable Option?

Those who want more comprehensive dental benefits in Sun City might consider a standalone dental insurance policy. They're offered by most insurance companies and usually have several pricing options that will vary by the type of plan selected. An example of the available options is as follows:

Basic Plans

Basic plans will generally cover annual examinations and evaluations, prophylactic services, and diagnostic x-rays.

Mid-Range Plans

The middle price range will provide expanded services for emergency treatment, dentures, fillings, inhalation anesthesia, orthodontic work, and specialty x-rays.

Premium Plans

Premium plans provide the broadest range of dental procedures, but their monthly payments are also the most expensive. They may be the most cost-effective dental benefits in Sun City for those who need extensive dental treatment, and the covered services include:

• Crowns
• Endodontic procedures
• Full dentures
• Inlays and onlays
• Oral surgery
• Partial dentures
• Periodontal procedures

Although an insurance plan will help with the cost of these procedures, the tiered pricing structure means that you may be responsible for partial payment for your procedure. The tiered rate is usually 100-80-50, which means that routine dental procedures are 100% covered, while basic procedures are covered at 80%, and complex procedures are covered at 50%. You'll be responsible for the balance of the cost for basic and complex procedures. While private dental plans may be less expensive than an Advantage plan, you'll probably not receive the hearing, prescription, and vision benefits that an Advantage plan provides.

Are There Advantages to Dental Discount Plans?

A dental discount plan may help you reduce the cost of your overall dental expenses, but it's not an insurance plan. Dentists who accept discount dental plans agree to accept discounted rates from members who need their services. Members pay an enrollment fee and a monthly membership fee and then pay the dentist directly for their services. Discount plans have some advantages over insurance plans because they're affordable and mostly non-restrictive. For example, there are no:

• waiting periods for dental benefits in any area of the country;
• forms to complete;
• annual limits on office visits;
• exclusions for pre-existing conditions;
• copays, deductibles or coinsurance obligations; or
• restrictions on changing dentists

They may have more limited coverage than traditional insurance plans, but may provide a substantial savings for routine procedures, such as:

• Annual checkups and examinations
• Crowns
• Dental prophylactic services
• Dentures
• Extractions
• Fillings
• Root canals
• X-rays

Companies such as Smile Alliance Club include discounts for hearing and vision services as well as a prescription drug benefit that can provide a substantial savings over the course of a year. Discount plans are more viable for those who are in overall good health and only require routine maintenance procedures. If you need more extensive dentistry, then a standalone insurance plan may be more cost-effective.

How Can I Manage Out-of-pocket Expenses?

Most dental offices provide flexible financing options and payment options. CareCredit is one of the most popular financing companies and it's accepted at more than 200,000 providers nationwide. Medical credit companies provide short-term financing for medical and dental procedures but they require an application and an approval process and not everyone will qualify for financing.

Some senior organizations such as AMAC or AARP provide senior discounts for professional services as well as insurance, so they're another source of savings for seniors.

If you need dental services in the Sun City area, then call us and let us help you. We'd love to speak with you. We'll enable you to get the dental services you need at a price that you can afford, so don't forego needed dentistry because you lack dental benefits in Sun City. Call us today and let's get started on regaining your good oral health.