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Dental Benefits for Seniors: Choosing Between Standard Insurance, Discount Plans, and Medicare Advantage in Hudson Valley
Because of the lack of affordable dental benefit options, many seniors are forced to either go without essential dental services or pay exorbitant out-of-pocket costs for basic procedures. Sadly, seniors are also the demographic most likely to experience dental issues because of age, years of dental neglect, or chronic health conditions. Despite the lack of insurance options, the rate of dental spending among seniors is increasing faster than among any other segment of the population. For example, the number of seniors visiting a dentist in a year increased by approximately 6 million between 2006 and 2016. The total amount spent by seniors on dental services totaled nearly $28 billion in 2016.
Standalone insurance or some other form of dental benefits in Hudson Valley is often the only way patients can afford dental care. A Kaiser Family Foundation survey found that only half of Medicare recipients had received dental services in the past year and that 19% of those visiting a dentist incurred out-of-pocket expenses exceeding $1,000. Although prices can vary from patient to patient and practice to practice, the following are examples of what patients without dental benefits in Hudson Valley can expect to pay 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 Options for Dental Benefits in Hudson Valley?
Many seniors are surprised by the lack of affordable alternatives for dental benefits. Employer-sponsored plans are no longer an option after retirement. Medicare, which is the sole source of health benefits for many seniors, only covers dental services in very limited circumstances. For example, a basic exam may be covered under Medicare Part A hospital benefits if the exam is a necessary part of another covered procedure. An estimated 65% of seniors have no dental coverage at all. This percentage is increasing rapidly as more and more baby boomers retire or reach the age of 65 every day. Approximately 25% of those with coverage receive their benefits through a Medicare Advantage plan. The remaining 10% opt for a standalone dental plan purchased from a private insurer.
Do Medicare Advantage Plans Offer Comprehensive Dental Coverage?
Although they may not offer comprehensive dental coverage, Medicare Advantage supplement plans are a relatively affordable way to get basic dental coverage. Medicare supplements provide you with access to qualified providers as well as price protection in the form of low deductibles and out-of-pocket spending caps. You purchase these plans directly from a private insurer, such as UHC, Humana, or Aetna. The insurer is responsible for reimbursing the health care provider for covered services rather than the federal government. Since the plan is separate from your basic Medicare coverage, you will receive a second ID card in addition to the standard red, white, and blue Medicare card. For around $420 per year, you get benefits for vision and hearing services, prescriptions, and dental services. The dental coverage, however, is generally limited to prophylactic services, such as cleanings, basic exams, and standard X-rays.
Can I Afford a Dental Insurance Plan?
Private dental insurance is not as expensive as you might think. In fact, a Bankrate survey found that the average cost was only $350 per year, which is less than the cost of a cup of coffee per day. You can also customize your dental coverage by choosing from various levels of plans, so you don’t end up paying for services that you are unlikely to use.
Basic Dental Plans:
As the name suggests, basic dental plans are normally limited to prophylactic services, such as exams, routine cleanings, and standard X-rays.
Mid-Level Dental Plans:
If you are looking for a plan that offers broader coverage at a price that won’t break the bank, you may want to consider a mid-level plan. For just a few dollars more a month, you will receive expanded coverage for fillings, dentures, emergency treatments, inhalation anesthesia, specialized X-rays, and orthodontics.
Premium Dental Plans:
For the most comprehensive coverage, you would need to invest in a premium dental plan. This type of plan is ideal for seniors who may need endodontic or periodontic procedures, oral surgery, crowns or other dental restorations, or complete or partial dentures.
While the premiums for standalone dental insurance are generally less than those for Medicare Advantage plans, they normally do not include extended benefits for vision, prescription, or hearing services.
Do Dental Discount Plans Work the Same as Standalone Dental Insurance?
A dental discount plan is one of the most affordable ways to save money on dental services. Sold by private companies, discount plans work a little differently than insurance plans. For example, members pay a minimal enrollment and monthly membership fee instead of a monthly or annual premium. Members then pay the dentist directly for the service at a pre-negotiated flat rate rather than the plan provider reimbursing the dentist. These plans can help you save anywhere from 20% to 80% on many common dental services, including:
- Routine cleanings
- Basic exams
- Root canals
- Crowns and other restorations
- Standard X-rays
Discount plans cost far less than Medicare supplements or standalone insurance and offer advantages not available with traditional insurance, including:
- Your benefits go into effect right away.
- You can use your benefits as many times as you want during the year.
- You can change dentists at any time. You can also use your benefits while traveling as long as the dentist participates in the plan.
- While private insurers often deny coverage on the basis of age or preexisting conditions, discount plans are open to anyone.
- The prices for services are negotiated ahead of time, so you don’t have to worry about claim forms or other time-consuming paperwork.
Most popular discount plans, such as DentRite®, also offer discounts on other health and wellness services, such as vision, hearing, and prescription drugs. Keep in mind, however, that the benefits offered for complex procedures are not as comprehensive as you might find with traditional insurance. A standalone insurance plan may still be your best option if you need extensive dental work.
What Options Do I Have for Managing Out-of-pocket Dental Expenses?
Even without dental benefits, you may still be able to manage the cost of your dental treatment with the help of a medical financing plan. For example, CareCredit offers both short-term and long-term financing ranging from 24 to 60 months for medical and dental services depending on the amount being financed. CareCredit is accepted by hundreds of thousands of health and wellness providers throughout the United States. Of course, you do have to go through an application and approval process. This means that you might not qualify if you have a blemished credit history.
Finally, you can also turn to AARP and other senior advocacy organizations for more information on insurance options and discounts for seniors to help cover the costs of dental care.