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Understanding the Ins and Outs of Dental Benefits and Medicare Advantage in Central Brandon
A recent survey found that approximately 65% of adults over the age of 65 do not have dental coverage. One reason for this is that most Americans get their dental insurance through their employer and struggle to find an affordable replacement option when they leave the workforce. The second reason is that Medicare, which is the primary health care coverage for most seniors, does not include benefits for dental services.
Is It Important for Seniors to Have Dental Benefits in Central Brandon?
There are several reasons why it is important for seniors to consider their options for dental benefits in Central Brandon:
- Seniors are generally the age group most in need of dental services.
- During 2016 alone, seniors spent more than $28 billion on dental services
- According to the American Dental Association Health Policy Institute, 6 million more seniors visited the dentist in 2016 than in 2006. This number is likely to continue to grow since approximately 10,000 Americans turn 65 every day.
- The rate of dental spending among seniors is growing faster than any other demographic group.
- Only half of Medicare recipients report seeing a dentist in the past year.
- Approximately 19% of Medicare recipients who visited the dentist report paying out-of-pocket expenses in excess of $1,000.
- Traditional Medicare only covers basic dental services if they are required as part of a treatment or procedure covered under Medicare Part A hospital benefits. An example would be a basic dental exam required as part of presurgical clearance.
What is the Average Cost of Dental Care Without Insurance?
The cost of routine preventative dental services can easily amount to hundreds of dollars, and the cost of advanced treatments can reach into the thousands of dollars. The following are examples of what you can expect to pay for common dental services. Keep in mind, however, that prices can vary based on your location and the exact nature of your dental issues:
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 Options Do I Have for Dental Benefits in Central Brandon?
Most seniors looking for dental coverage typically choose a Medicare Advantage plan or private dental insurance. Even without insurance coverage, there are ways to make the cost of dental services more affordable and manageable, such as discount plans and financing options.
Does Medicare Advantage Pay for Dental Services?
Approximately 25% of Medicare recipients receive dental coverage by enrolling in Medicare Advantage plans. These are supplemental plans offered by private insurers, such as Human, UHC, and Aetna, that provide benefits above and beyond those offered by traditional Medicare. While services covered by basic Medicare are reimbursed by the government, it is the insurer that reimburses providers under Medicare supplement plans. Since supplement plans are separate from standard Medicare, you normally will receive a separate ID card in addition to the red, white, and blue Medicare card. In addition to providing access to a wide network of qualified providers, Medicare Advantage plans offer price protection and cost-sharing measures, such as limits on out-of-pocket expenses and low deductibles. Medicare supplement plans typically cover prescription costs and offer vision, hearing, and dental benefits. The average cost of a Medicare supplement is typically low per year. Dental coverage normally includes cleanings, basic exams, and X-rays.
Should I Choose Standalone Dental Insurance?
Approximately 10% of Medicare recipients get their dental coverage through a private dental plan. Private dental plans provide more comprehensive dental coverage than Medicare supplement plans; however, they do not normally include vision, hearing, or prescription benefits. Most insurers allow you to choose from different plan levels, so you can select the plan that best fits your needs and budget. The average cost of private dental coverage is around hundreds of dollars per year.
How Much Does Standalone Dental Insurance Cover?
Regardless of the type of dental plan that you choose, most plans will pay a percentage of the cost based on the complexity of the service. For example, a basic exam may be covered at 100%, a filling at 80%, and a crown or root canal at 50%. The higher the level of the plan, the more expansive the benefits. For example:
As the name suggests, these plans normally only cover maintenance and prophylactic services, such as cleanings, exams, and X-rays. This type of plan may work well if you are in good oral health but may leave you with considerable out-of-pocket expenses if you need an advanced dental procedure.
These plans include additional benefits for more advanced treatments, such as orthodontics, emergency procedures, specialized X-rays, fillings, dentures, and inhalation anesthesia.
Most top-tier plans include at least partial coverage for advance services, such as root canals, endodontic and periodontic procedures, oral surgery, crowns and other types of restorations, and dentures. Although these plans have the highest price tag, they can save you money in the long run if you have significant dental issues.
Are Dental Discount Plans Worth the Money?
Discount plans are an increasingly popular way to make dental services more affordable. Dentists who accept discount plans, such as DentRite, agree to accept pre-negotiated discounted rates for common services, including: checkups, X-rays, extractions, crowns, root canals, dentures, fillings, and routine cleanings.
When you enroll in a discount plan, you pay an enrollment fee and a monthly membership fee instead of a monthly or annual premium. You then pay the dentist directly at the discounted rate.
There are several ways in which discount plans differ from insurance:
- You can use your benefits right away without worrying about waiting periods.
- You normally cannot be denied on the basis of age or pre-existing conditions.
- You don’t have to wait until the next enrollment period to change providers.
- There are no restrictions on the number of times that you can use your benefits during the year.
- You don’t have to submit claim forms or paperwork.
- There are no copays, deductibles, or coinsurance requirements.
Most discount plans also include benefits for prescriptions and vision and hearing services. You should keep in mind that discount plans are not insurance and do not provide the same level of coverage as insurance, so you may be better off with traditional insurance if you require extensive dental work.
What Is the Best Way to Manage Out-of-Pocket Dental Expenses Without Insurance?
Even without insurance or a discount plan, most dentists offer payment and financing options that can help you manage the cost of dental services. One example is CareCredit, which is a popular medical credit provider that is accepted by hundreds of thousands of providers and facilities across the country. Some plans let you finance balances for up to 24 months with no interest as long as you pay the balance in full by the end of the promotional period. Most finance companies also offer long-term financing of up to 60 months for large balances. Of course, financing is not without its drawbacks. You do have to go through a credit approval process to qualify. The interest, which normally averages between 15% to 20%, can also add significantly to the final cost of your care.
AARP and other senior organizations are great places to look for information on discounts on professional services, including dentists, and insurance options geared toward seniors.