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What Types of Dental Services Are Covered by Medicare Advantage in Tampa?
Have you thought about how you will pay for dental services once you reach the age of 65 or retire? Most Americans rely on employer-sponsored dental plans, so they are surprised by the lack of affordable dental care options for seniors. While most seniors rely on government-sponsored Medicare for their health care benefits, traditional Medicare does not normally cover dental services. Medicare only provides limited dental coverage under Part A hospital benefits if the service is required as part of another covered procedure. For example, a basic dental exam included in a pre-surgical clearance may be covered. Routine cleanings, X-rays, and exams are not covered.
Do I Really Need to Worry About Dental Benefits in Tampa?
Age, lifestyle, and chronic health conditions can take their toll on the teeth, which means that seniors normally face an increased need for dental services. The following statistics underscore just how important it can be for seniors to have dental benefits in Tampa:
- The growth rate for spending on dental services is higher among seniors than any other demographic group. In fact, seniors spent more than $28 billion on dental services in 2016 alone.
- The American Dental Association Health Policy Institute estimates that the number of seniors visiting the dentist each year increased by 6 million between 2006 and 2016.
- Because of the lack of insurance coverage and budget concerns, nearly half of Medicare recipients surveyed by the Kaiser Family Foundation stated that they had not seen a dentist in the past year.
Unfortunately, nearly 65% of seniors on Medicare have no form of dental coverage, which can mean hundreds or even thousands of dollars in out-of-pocket expenses for even relatively minor dental procedures.
What Type of Dental Expenses Can I Face Without Insurance?
A study by the Kaiser Family Foundation found that 19% of Medicaid recipients who reported seeing the dentist in the past year ended up paying more than $1,000 out of pocket. The following are examples of the types of expenses that you might face if you choose to not get dental coverage:
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.
Can I Get Comprehensive Dental Benefits in Tampa?
Options for dental benefits typically include Medicare supplement plans and private insurance. The annual premiums for both options are relatively modest, so they work for most budgets. If you are looking for more nontraditional options, you may consider a dental service discount plan or look for a dentist that offers payment arrangements or financing options.
Do Medicare Advantage Plans Cover Dental?
Medicare Advantage plans are optional supplements that you can purchase to expand the benefits offered by traditional Medicare. Approximately 25% of Medicare recipients opt for Medicare Advantage supplements for their dental coverage. These plans also normally include benefits for hearing and vision services. These plans are offered by private insurers, such as UHC, Humana, and Aetna, rather than the federal government. This means that you will have two ID cards: the red, white, and blue one for your traditional Medicare and a separate one for your supplement. The average Medicare Advantage plan may cost around $400 per year, so they are relatively affordable. The dental benefits, however, are generally limited to exams, cleanings, and basic preventative services.
What Are My Options for Standalone Dental Insurance?
Standalone dental plans offer the most comprehensive coverage for dental services, which means that are often the best choice for individuals with significant dental issues. It is important to keep in mind that even the best plan may only cover 50% to 80% of the cost of certain complex dental services, so you may still have out-of-pocket expenses.
Which Standalone Dental Insurance Plan Should I Choose?
Most private insurers allow consumers to choose from a range of plans and coverage options based on their needs and budget. The types of services covered and the percentage of the cost of a service that is covered vary based on the level of plan chosen. For example:
Basic Dental Plans:
Basic dental insurance plans are geared toward individuals who are in good oral health and who are primarily interested in maintenance and preventative dental care. Basic plans normally cover routine cleanings, exams, and X-rays.
Mid-Level Dental Plans:
These plans normally cover the same maintenance and preventative services as basic plans as well as expanded coverage for dentures, fillings, orthodontics, emergency dental services, specialized X-rays, and even inhalation anesthesia.
Premium Dental Plans:
In addition to the coverage provided by lower-level plans, top-tier dental plans often include at least some benefits for advanced dental services, including: periodontic and endodontic procedures, oral surgery, dentures and other tooth replacement options, inlays and onlays, and crown restorations.
In general, plans may be lower in price than Medicare supplements; however, you likely will not receive the additional vision, hearing, and prescription benefits.
Are Dental Discount Plans a Viable Alternative to Dental Insurance?
Before you purchase a dental service discount plan, it is important to understand that these plans are not insurance. These plans are offered by private companies that have negotiated discounted rates with participating dentists. Instead of a premium, you pay an enrollment fee and a low monthly membership fee. You then pay the dentist directly at the discounted rate. The coverage offered by these plans is not as extensive as traditional insurance, so you may be better off with an insurance plan if you anticipate that you might need extensive dental work. Discount plans, such as DentRite, can help you save money on common services, including: routine extractions, fillings, exams, X-rays, cleanings, root canals, crowns, and dentures.
Discount plans also offer advantages not found with traditional insurance:
- Most plans also include additional benefits for hearing, vision, and prescription services.
- There are no waiting or exclusionary periods, so you can use your benefits right away.
- You don’t have to pay deductibles, copays, or coinsurance.
- You pay the provider directly, so you don’t have to worry about paperwork.
- You can use your benefits as many times as you want during the year.
- Most plans accept everyone regardless of pre-existing conditions or age.
- You can change your provider at any time.
Are There Financing and Payment Plans Available for Dental Care to Diminish Out-of-Pocket Expenses?
Many dentists offer payment plans and financing options that allow patients to spread the cost of their treatment across multiple payments. One example is CareCredit, which is accepted by more than 200,000 providers and facilities nationwide. Financing periods can range from 24 months up to 60 months depending on the amount being financed. Some medical credit providers even offer promotional periods with no interest if you pay the balance in full by the end of the promotional period. You need to keep in mind, however, that the entire amount of interest that you would have been charged will be applied to your balance if you do not pay your balance in full by the designated date. That can be a rather hefty sum since interest rates can range from 15% to 20%. Medical credit providers typically require the same type of application and approval process as any other type of credit provider.
Seniors should also check out AARP and other senior organizations since many of them offer discounts for professional services and information on insurance options.