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My mom is eligible for Medicaid, but it doesn't cover dental and she hasn't been to a dentist in many years. She has profound dementia and will require a special dentist facility. She has very little money in savings and I don't want to spend it out on dental work. So, I'm going to look into dental insurance but it seems even more varied and less coverage than regular health insurance and I don't know if it's generally worth it to just ask the dentist for a payment plan. Anyone have experience with this? Thanks so much!

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Did you confirm in writing that Medicaid would not cover her dental? I know that they do in NC. Here's a link about it. I would inquire specifically if they cover dental for those who are disabled. Here's a link for Wisconsin.

https://www.dhs.wisconsin.gov/medicaid/index.htm
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Thank you all for your thoughtful comments. I've found an insurance that covers the basics and 50% of the bigger procedures. The monthly cost is doable and we'll get her in and see what she can tolerate and what the dentist finds and if, over time, the insurance doesn't seem to balance out with the costs, then we'll either switch plans or look for alternatives. We are going with Delta Dental through AARP. I don't think she would be able to handle any dentures or implants at this stage, so we'll just have to see what the dentist finds out. She took such good care of her teeth for her whole adult life, so even though she's got some chipped teeth now (she loves to chew ice), I'm hoping that her molars are still solid and her gums are healthy. I had read about sedation dentistry, I wonder if anyone has had any experience with that? Thanks again!
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I did a lot of research before choosing a dental plan. It was time consuming, but necessary. I researched and compared plans in which our dentist was participating (we didn't want to change to get another dentist), listed services covered in the initial and following years, then compared the amount the insurance company would pay vs. out-of-pocket costs.

Then I did a break-even analysis to find the point at which the insurance would actually offer enough that it would be justified.

My determination was that it was justified for both of us, but after a year of so as the premiums were increased, my breakeven point changed and the insurance was no longer cost effective. And remember that the premiums likely will increase annually.

As pointed out, it doesn't cover everything the first year, nor does it cover higher cost procedures. So you'll need to review your bills for the past few years and determine whether, thus far, the needs appear to be for the bascs, or for extraordinary expenses like root canals, bridges, and more.
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Spending on dental is something my mom did in the years before going into a NH. It was really worthwhile for her to get rid of her oldschool bridges, big silver fillings and instead get implants, crowns and gum work done. Even with insurance & discounts the tally she paid easily over 40K and this was a few years ago. My Mom had lewy body dementia, so was very much still cognitive & competent at this point in her dementia. If your mom has years of neglect or other trauma to her mouth, I'd bet she will be advised to get implants which run about 5-8K per post and usually require gum work before implants done. Your mom may need medical clearance forms from all her MDs before dentist will start treatments as well.

If your mom has profound dementia, please, please, please before you sign up & start payments, think about if mom can totally on her own......hold a small cup with water, sip, swish & spit on command; lay at an incline for 30 minutes to an hour; can bite & hold an X-ray plate and be still long enough to get bitewings & other X-rays done; stand & hold still for the panoramas; hold her mouth open & fixed in one direction for a full 5 minutes; and would she be able to have the wet, oozy and odd tasting form used to get impressions go into her mouth & sit for the length of time needed to pull a clean impression (this last one can be impossible). If not, it's going to be costly epic fail imho.

Also can she (& you) be able to do the series of timed appointments needed for many procedures?

Also look carefully at policies. Most dental insurance is geared to paying for twice a year cleaning & exam, annual bitewings at full coverage; filings into sound teeth with healthy gums have good coverage as well. But coverage on work done by endodondists, oral surgeons or other specialists may be less than 1/3. Often policies do NOT pay the dentist until the full treatment is done, so a lot of dentists -especially those specialists that require several visits to complete a treatment - will not participate with some insurers because of this.

One bright spot in this is if, there is going to be anesthesia needed (like for extractions or bone work) then your medical insurance may cover all or part of the anesthesia if done by a oral surgeon.

For my mom, spend-down on dental was well worth it as it just sped up her eventual eligibility for NH Medicaid and she was able to have a pretty normal diet and bite into food till really her last month or so. The whole cut up or hold food then bite /chew /swallow helps to help keep them cognitive & have a more varied diet & they need teeth to do this. My mom was fortunate to have had $ to pay dental costs & she had pretty sound teeth & good gums to start with. But if she hadn't had the $, and had teeth issues, she probably would have done full dentures which I believe Medicare will pay for. Really look carefully at what the costs could be and whether mom can actually participate in the care needed before she gets on the hook for costs. good luck.
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It is more expensive than other insurances and it only covers about half. If she has profound dementia, she is not about to let a dentist stick stuff in her mouth.
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