Medicare Advantage dental benefits in Denville (Seniors 65+)

While it’s common for seniors to go without dental coverage, spending on dental services is up older adults. This demographic spent $28 billion on dental services in 2016, representing the highest growth rate among all age groups. Plus, more seniors are seeing a dentist regularly – in 2016, 6 million more seniors received a dental checkup, says the American Dental Association Health Policy Institute. However, not all seniors are receiving the care they need – nearly half of those currently using Medicare did not visit the dentist. Among seniors who did book a dental visit, 19% spent $1,000 or more out of pocket, according to a Kaiser Family Foundation study. Below is a list of typical dental procedures and their 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.

Do Seniors Have Different Options for Dental Insurance?

If you’re a senior faced with dental costs, you may be wondering what insurance options are available to you. One option for those over 65 is Medicare, a nationally funded healthcare program in the United States. All adults over 65 and those who are permanently disabled are automatically enrolled in Medicare. Recipients receive a red, white, and blue ID card to use when receiving care. Medicare covers many common medical procedures, but it does not cover routine dentistry. In fact, Part A benefits may only apply to a dental exam if it’s a necessary part of a covered procedure, such as a surgery.

With limited dental coverage options through Medicare, many seniors are looking for affordable dental benefits in Denville through independent providers. Overall, 10% of seniors will choose private insurance while a quarter will opt for a Medicare Advantage plan.

What Are Medicare Advantage Plans?

Provided by private companies and completely optional, Medicare Advantage plans are used to supplement your existing Medicare coverage and expand your access to affordable care. Participants can choose from a larger provider network and have price protection via out-of-pocket maximums, low deductibles, and cost-sharing measures. While the government reimburses medical costs with a traditional Medicare plan, a private company reimburses costs under a Medicare Advantage plan. Popular Advantage plan providers include Cigna, UHC, and Aetna. When you enroll, you’ll receive an ID card much like you would a traditional insurance plan.

Advantage plans offer dental care benefits, but they can also help you save money on vision care, prescription drugs, and other services. Another benefit of Advantage plans are that they are usually quite affordable with low premiums – the average annual cost of an Advantage plan last year was $420. While many preventive services are covered, more extensive dental treatment may not be included in the plan’s coverage. If you’ll require intensive dental treatment, you may save more with a traditional plan.

Should I Get Standalone Dental Insurance?

If you’re looking for comprehensive dental benefits in Denville, a standalone plan may be right for you. These are also provided by private insurance companies and they offer varying levels of coverage with different premium costs. Your individual costs, copays, and coinsurance requirements will depend on the level of coverage you select. Many plans offer three types of coverage, including:

Basic Plans: Most basic plans cover preventive care, including routine dental exams and tooth cleanings, X-rays, and other diagnostic services.

Mid-level Plans: Expanded coverage is included with a mid-level plan, which often includes emergency dental care, specialized X-rays, inhalation sedation, dentures, and tooth fillings.

Premium Plans: Premium plans offer the most coverage for advanced dental treatment – usually partial to full coverage. Covered services include oral surgeries, complicated restorations, and other procedures. If you will require several procedures to correct your dental health issues, a premium plan may be a good option. Services covered include:

• Dental inlays and onlays
• Dental crowns
• Endodontic treatment
• Dental surgeries
• Periodontal disease treatment

Private plans sometimes determine coverage using a “100-80-50” system. In this case, routine services are fully covered, basic treatment is covered at 80%, and more intensive treatment is covered at 50%. According to data from Bankrate, private dental coverage cost patients an average of $350 last year. Traditional insurance tends to be lower in cost than Medicare supplements, but they typically do not offer additional prescription drug, eye care, or hearing aid benefits.

Is a Dental Discount Plan an Alternative to Insurance?

Offered by independent companies much like standalone insurance options, discount plans provide savings on common dental services – but they are not insurance. Instead, the discount plan provider reaches an agreement with healthcare facilities where they accept lower rates for services. Then, the provider passes the savings onto members, who pay a monthly membership fee. Discount plan members pay the dentist directly, presenting their membership card at the time of treatment.

Generally, dental discount plans offer several advantages worth considering if you’re looking for an alternative to standalone dental insurance:

• There are no copays, deductibles, or coinsurance requirements
• There is no waiting period before seeing a dentist
• You can change providers at any time
• There is no claims process, meaning no paperwork to fill out
• There are no exclusions for preexisting conditions or age limits

While a discount plan may not cover as much as traditional insurance, they can make many common procedures more budget-friendly. Listed below are examples of discounted services:

• Routine dental checkups and cleanings
• X-rays
• Dental extractions
• Tooth crowns and fillings
• Root canals

Discount plans – including Smile Alliance Club Plus – also offer exclusive member savings on prescription eyewear, hearing aids, prescription medication and more. Those in generally good dental health who will only require maintenance services may opt to use a discount plan for their dental needs. However, those whose oral health challenges that are severe may save more money with traditional insurance.

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

If you’re on a budget, flexible financing is one way to make dental costs more manageable. CareCredit is one popular financing provider that’s accepted at over 200,000 healthcare providers nationwide. Many payment options offer interest-free short-term financing if the balance is paid within a promotional period. Long-term financing of up to 60 months is also available for larger purchases. While choosing flexible financing may make managing costs easier, it does have some disadvantages:

• Dental payment options require an application and credit check, meaning that not every patient will qualify.
• Some payment options have interest rates between 15-20%, adding to the overall cost of care.

Navigating the world of insurance can be challenging, and we’re here to help. If you have questions about Medicare Advantage supplements, flexible financing or discount plans, contact our office, the AARP, or your local seniors’ organization for more details.