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Those who are more than 65 years old comprise almost 20% of the population, yet their access to adequate dental care is among the lowest in the nation due to lack of insurance. Most Americans have dental and medical insurance coverage through their employer, but when seniors retire, most lose their insurance coverage, so they must do without or pay out of pocket. Those who do without comprise more than two-thirds of the senior demographic, and since more than 10,000 Americans turn 65 daily, those numbers are going to increase dramatically.
Even without insurance, in 2016, seniors spent more than $28 billion on dental bills — more than any other demographic. The ADA, or American Dental Association, reports an increase of 6 million seniors visiting the dentist between 2006 to 2016, and this trend is expected to continue. Kaiser Family Foundation reports that almost half of Medicare recipients hadn’t obtained dental services in more than a year and almost 20% of those who had, incurred more than $1,000 in out-of-pocket expenses for procedures. Dental costs are expensive, as is evidenced by the following typical costs for common 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.
Do Seniors Have Any Dental Insurance Options?
Those who turn 65 are immediately and automatically enrolled in traditional Medicare and receive the red, white, and blue identification card. However, Medicare doesn’t provide dental benefits except if they’re necessary for a surgical procedure, and then they’re paid under the hospitalization section of Part A. Therefore, those seniors who want to maintain their good oral health, which is an integral part of their overall good health, must resort to private insurance carriers for a dental plan. About 10% of seniors carry private dental insurance, and about 25% enroll in an Advantage plan.
How Does a Medicare Advantage Plan Provide Benefits?
Medicare Advantage plans are supplemental insurance plans that work in conjunction with your traditional Medicare plan. You’ll have access to a variety of qualified providers and you’ll have low deductibles, lower out-of-pocket limits, and other cost-saving measures. Unlike traditional Medicare, however, an Advantage plan reimburses the provider directly, so that they don’t have to wait for government reimbursement. Advantage plans are offered by insurance companies such as Aetna, United Healthcare, and Humana, and they often include vision and prescription benefits in addition to the dental benefits. Members of an Advantage plan will receive a separate ID card, and according to MedicareAdvantage.com, the 2018 annual average premium for Medicare Advantage plans was about $420 and Humana, Aetna, and United Healthcare were among the most popular for Advantage plans. If you’d like more information on an Advantage plan that’s right for you, call our Rockledge office and we’ll be glad to help you.
Would Standalone Dental Insurance Reduce My Out-of-pocket Expenses?
A standalone dental insurance plan may provide you with a broader selection of dental benefits in your area as well as reduced rates on others. Usually, you’ll have a selection of price points from which to select and those with a higher premium will cover more services. For more information on dental benefits in Rockledge and insurance policies that are available, please call our Rockledge office and we’ll be happy to answer all of your questions; however, the following list will provide an overview of your plan options.
Basic plans will generally cover examinations and evaluations, dental cleanings, and diagnostic x-rays.
The middle price range will provide some expanded services for emergency treatment, fillings and dentures, orthodontic work, specialty x-rays, inhalation anesthesia and more.
Premium plans provide the most comprehensive coverage but their monthly payments are also the highest. They’re the most cost-effective for those who require significant dental care, and the covered services include:
- Full and partial dentures
- Endodontic procedures
- Onlays and inlays
- Oral surgery
- Periodontal procedures
Private plans provide tiered coverage, which means that you’ll be responsible for part of many procedures. Usually, the rate is 100-80-50, which means that the cost of routine procedures is 100% covered, the cost of basic procedures is covered at 80%, and the cost of complex procedures is 50% covered by the provider and 50% is the patient’s responsibility. According to Bankrate, private dental plan costs average about $350 annually, which may be lower than a Medicare Advantage plan, but it won’t include any hearing, vision or prescription medication benefits that may be included with an Advantage plan.
Are Dental Discount Plans Better Than a Private Insurance Plan?
Discount dental plans aren’t insurance plans and are provided by private enterprises. Under a discount plan, a dentist agrees to provide services for a lower rate than would normally be charged and the dentist is paid directly by the patient. Discount plans have an enrollment fee and a monthly membership fee rather than a monthly premium. They don’t offer as much coverage as a traditional insurance plan, but they can be more advantageous than an insurance plan since 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; or
- copays, deductibles or coinsurance obligations.
Generally, a discount plan will provide a substantial reduction in the cost of:
- Routine exams
- Dental cleanings
- Extractions and fillings
- Root canals
Some discount plans such as DentRite offer hearing, vision, and prescription drug discounts as well as their dental discounts. For those who are in overall good health and want basic coverage, one of the popular discount dental plans may provide the cost-effective treatment you need. However, if you need more comprehensive dental work, then an insurance plan may be more advisable for you. Call our Rockledge office for more information about dental benefits in Rockledge or if you need to schedule a consultation, and we’ll be happy to answer all of your questions.
How Can I Control My Out-of-pocket Expenses?
If you need dental work, many dentists offer flexible financing and payment options that will help you with your out-of-pocket expenses. CareCredit, which is offered by many dentists, is available through more than 200,000 providers throughout the nation, so that can help make dental expenses more affordable. Medical credit companies sometimes offer 24-month, same-as-cash options, and interest fees are avoided as long as the balance is repaid within the time specified. Some 60-month options are available but these aren’t usually same-as-cash programs. The drawback to credit companies is the interest rate, which starts at 15% and can go to more than 20%, which will add substantially to the cost of the procedure. Also, not everyone will qualify for a financing option. An application and an approval process guarantee that some will not qualify for financing, but several senior resources, such as AARP and AMAC, can provide additional discounts that will enable you to afford the dental procedures that you need.
If you’re a senior who needs dental work but can’t afford it, then contact Rockledge Dental at (321) 252-0825 and let us help you with your dental benefits in Rockledge. We’ll do our utmost to provide you with the procedures that you need at a price that will fit within your budget. We look forward to speaking with you and helping you regain your good dental health, so call us.