Dental Insurance for Seniors on Medicare…sadly, is very limited at best. Medicare Dental coverage is almost nonexistent and that is a real problem.
How many times did your mom or dad ask you as a child… “did you brush your teeth?” How many times did you hear the hygienist at the dentist office ask “have you been flossing? Your gums are bleeding.”
Most of us have been brought up with the idea that we need to take good care of our teeth. All of this advice is certainly very important, especially as we get older. As we age, dental issues become a greater challenge to stay on top of. In general, dental care expenses in most cases will rise. Here are a few of the common problems that seniors can experience, according to the National Institute of Health:
- Gum disease
- Tooth loss
- Oral cancer
- Facial pain
This list doesn’t even cover all of the the diseases that can be caused by dental problems. There is evidence that it can lead to an increased risk of cancer or heart disease, not to mention embarrassment and lack of self confidence from missing teeth that inhibit a confident smile.
Now the trouble is…
While Medicare covers a lot of healthcare issues, it does not cover most dental care. For more information on your possible alternatives read this article.
Now, Medicare will cover care if you sustain a broken jaw if you are in an accident, but not the actual cleaning or tooth extraction.
Does Medicare pay for dentures? No. Sorry to say…dentures are not covered either.
So what you have as a recipient is very limited and not well rounded and/or preventative dental care.
Best Medicare Dental Plans? What Are Your Medicare Dental Plan Options?
Bad news here folks!! Medicare does not not offer dental plans at all. However, some folks choose Medicare Advantage (Part C of Medicare) which may include some respectable dental benefits.
Many Medicare Advantage plans include dental and/or vision coverage as part of the program. Be sure to verify the limitations though. Remember, Medicare Advantage is a private program. Medicare does not administer the claims as is not original Medicare (Part A, Part B). You cannot just add Part C to get dental and vision. Your either on Original Medicare which offers full control of your providers or a private HMO or PPO managed by a for profit insurance company.
If you are on Original Medicare (most people) then you may already know that Medicare is not your “dental, vision and hearing coverage.” Now, even if you are or will be receiving dental care through a Medicare Advantage (Part C) plan, you still may find you are better off with a private dental plan. What specific services are covered in your Medicare Advantage plan? Does it provide other valuable services like Vision and Hearing in the coverage?
The best dental insurance for seniors on Medicare will deliver extensive coverage you can use regularly, such as cleanings, fillings, x-rays, crowns etc. Consider looking for a policy that covers: preventive services, basic services and major services. While cleaning and x-ray coverage is nice, that is a small cost relative to the others. A crown can be $1000 quite easily. Make sure your insurance has you protected especially if you have had your share of dental problems in the past.
In summary, you have a couple of different options to obtain dental insurance for seniors:
- Medicare Advantage (MA) plans (Part C of Medicare)
- An individual private insurance company policy.
Option 2 has nothing to do with Medicare and is most often superior.
Review and take note of all the coverage you have now.
- Is there an out-of-pocket maximum?
- Is there an annual maximum benefit?
- What is the waiting period for services?
- What services are covered in the first year?
You will want to know:
- What is the monthly cost?
- Do I have a deductible? If so, how much?
- Is there co-insurance (i.e., the cost of a procedure)?
- What is the co-pay?
Yes, it is unfortunate that Medicare has not covered typical dental needs.
The question of dental coverage under Medicare comes up in Congress every now and then. It has not gained very much traction. Right now only “medically necessary” services are covered. For example, if you need dental services before radiation treatment for mouth (oral) cancer, you may qualify. Otherwise, your options under Medicare are very, very limited.
However, don’t let your dental health go down the tubes. You can still obtain very good dental coverage outside your Medicare plan that even includes vision and hearing coverage. Shop your Medicare supplement with an independent agent/broker that specializes in senior benefits. A good independent can quickly shop out your coverage to see who the offers the best rate in the state. They may be able to save you enough money to pick up most of the cost of your dental, vision and hearing care and keep you smiling all the way to the dentist office. Find out about the top Medigap/Medicare Supplement plans here.
Medicare Vision Coverage
If you have Part C of Medicare, Medicare vision coverage (for example) may be included. However, if you are on Original Medicare, you are out of luck and may want to consider obtaining separate senior dental, vision and hearing coverage. Dental, vision and hearing are all areas where Original Medicare disappoints.
What Can I Do About It? I’m On A Fixed Income.
As a senior, Original Medicare as a whole offers broad based healthcare benefits, but it is not without some limitations, even if you have a Medicare Supplement. Medicare Supplements only benefit you if Medicare approves the claim first. Major limitations are Dental, Vision and Hearing benefits. No Medicare Supplement will give you additional dental benefits.
With Original Medicare, you are pretty much on your own with Dental, Vision and Hearing expenses.
For those who have elected to go the non traditional route and elected Medicare Advantage (MA) as their coverage provider you may have a few perks that pick up some of your dental, vision and hearing. While MA is not Medicare dental coverage so to speak, it is a benefit found in some Medicare Advantage plans. Medicare Advantage is not Medicare, it is a private plan. In fact, you cannot use your red, white and blue card while on it.
Be sure to look at the extent of the dental coverage though. Don’t assume anything. There are no Medicare guidelines for dental care in a MA offering.
Does it cover major and minors such as cleanings and x-rays? Dentures, a major… that is something to verify as well.
The good news is that affordable and arguably the best dental insurance for seniors on Medicare is not hard to obtain. This type of traditional insurance will cover the preventative items such as cleaning or basic services as well as the major services. The top offerings will also include vision and hearing coverage and allow you to see any provider you wish rather than a network provider. As a senior you realize that all 3 of these tend to deteriorate with age.
Until the government takes some real action (don’t hold your breath), taking steps to resolve your dental coverage needs might make some sense.
Excellent options for seniors are out there right now. No, these are not Medicare dental plans. These are from private insurers. Options include full coverage to those wish to have dental, vision and hearing coverage in one tidy, affordable policy. The top policies certainly complement Original Medicare where it is lacking while rounding out your retirement benefits.
One of the keys to managing additional costs of adding dental insurance to your budget…be sure you are not being overcharged elsewhere on your insurance coverage. Too many times we have seen seniors being drastically overcharged on other insurance. In particular, Medigap plans (Medicare Supplemental Coverage).
I am not going to mention any insurance company names here. Some people are stuck there because of poor health. As a result, there is nothing they can do to change what they are paying for their Medicare Supplement and keep their benefits.
My point…make sure you have a competitively priced Medicare Supplement in place. Most seniors we work with are on a fixed income. Don’t be caught up in the hype of one company paying better than another. It is utter hogwash that will just empty your bank account, slowly but surely. Be mindful and astute about these costs and how they may effect you now and for the future.
Dental insurance for seniors is very valuable and important to have. There are so many reasons that care must be taken, especially as we age. Unfortunately, Medicare just does not get the job done leaving these expenses up to you. There are very good options for most seniors to rectify this while keeping your insurance costs down.
Talking with an independent specialist about your personal situation is advisable.
Trying to plug holes in Medicare can be frustrating. Dental needs, vision problems or a loss of hearing are very, very common. Get all your Medicare questions and concerns answered. Discuss your current coverage and get some feedback on what might be best for you to manage insurance costs. Affordable Dental insurance for seniors is an option you can look into.
We have the solutions here at Maple Valley Insurance Group. Contact Us @ 800-598-6445 to see how we can help you solve your dental dilemma and save money. No more worries about big dental bills or even the cost of getting new glasses every year or two.
If you have questions or comments about this article, feel free to leave it below. We try to respond as quickly as possible.