Dos and Don'ts: Dental Coverage for Seniors

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As a senior, you are more susceptible to certain oral health problems, like dry mouth, gum disease, and tooth loss, but you are also less likely than ever to have employer-sponsored dental insurance. That means it’s up to you to explore options for covering these costs. This includes costs for cleanings, dentures, implants and more. Here are a few dos and don’ts to keep in mind while researching dental health coverage choices.

DON’T Assume Medicare Covers Your Dental Care

Standard Medicare plans do not cover any routine procedures, like yearly cleanings, fillings, X-rays, or crowns, nor will Medicare pay for dentures. However, Medicare may help pick up the bill if an accident or disease causes you to have jaw issues that require medical attention, or if you require an exam prior to a serious medical procedure like a heart transplant. Your best bet is to assume that Medicare will NOT cover you in a specific situation and then plan accordingly.

DO Consider a Medicare Advantage Plan with Dental Benefits

If you want to be covered for routine dentist visits, it makes sense to explore the possibility of a Medicare Advantage Plan. Depending on which plan you choose, you may be eligible to have a variety of services covered, including not only cleanings and X-rays, but also more extensive procedures like fillings and even minor denture adjustments. You may also be able to receive additional savings on dentures, root canals, and bridges by choosing a plan that offers reduced fees for in-network dentists.

Selecting a Medicare Advantage plan that best fits your needs and budget can be tricky, so it’s worth consulting with a trusted health insurance agent to explore your options and make a decision.

DO Explore Standalone Insurance Plans

If you’re interested in dental coverage but don’t want to go to the expense of a Medicare Advantage plan that offers these benefits, a standalone insurance plan may be the best choice. As with all insurance needs, make sure that you decide what you really need, then research before settling on a plan. Do you want a plan that simply covers routine cleanings and exams, or are you interested in a plan that also offers endodontic or denture care? Do you want to continue seeing the dentist you’ve gone to for years, or are you willing to switch to another care provider that’s in-network for your new plan? Also, how long is each plan’s waiting period before you become eligible for coverage? Compare copays, deductibles, benefit maximums, and other plan elements to make sure you’re selecting the plan that best meets your needs.

DON’T Ignore Dental Discount Programs

Some dentists participate in discount programs, where a network of care providers agree to accept lower rates for common services like exams and cleanings. In this scenario, you pay a fee to access the network and receive a membership card that makes you eligible to receive the reduced rates from dentists who are part of the discount network. While the savings aren’t as large as those from specialized insurance policies, it’s better than not saving anything. A discount program may be a viable alternative that can save you money.

Planning for Your Oral Health is a Smart Move

Don’t forget your teeth when planning health insurance needs as a senior. Realize that Medicare doesn’t cover most oral health costs, so be sure to check out a Medicare Advantage plan or standalone insurance policy to help defray costs. If insurance isn’t an option, see if a discount program would work instead. The planning done today will help you save money—and maybe even your smile—in the future.

Ryan Smolek is the Vice President of Marketplace Operation for GoHealth Insurance, the nation’s most complete online portal for finding health insurance coverage. Possessing the experience, technology and infrastructure procured over the past decade, GoHealth is committed to the continual strengthening of the health insurance community.

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1 Comments

Too general to be useful IMO