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!! Original Medicare does not not offer dental coverage at all. However, some folks choose Medicare Advantage (Part C of Medicare) which may include some respectable dental benefits. Medicare Advantage is not Medicare though.
Yes, I know it sounds like it but actually…
It is a privately administered health care coverage offered by insurance companies as an alternative to Original Medicare.
In fact, you cannot use your red, white and blue card while on it. Tuck that card away in a safe spot, but you will not need it unless you are on Original Medicare.
Medicare does not pay any part of your claims under this private program. As such, Medicare Advantage companies can provide dental coverage in their plan.
Don’t assume the private insurer may or may not have dental in the private programs they have created. Be sure to review all benefits and limitations built into a Medicare Advantage plan.
You must leave Original Medicare to have access to this private healthcare. Medicare Advantage is delivered through a PPO or HMO network.
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.
Having access to the top providers under Original Medicare does not come without some sacrifice. As a beneficiary, you are pretty much on your own with any Dental, Vision and Hearing expenses. This is the weaknesses of the federal program.
For those who have elected to go the non traditional route choosing Medicare Advantage (MA), you may have a few perks that pick up some of your dental insurance needs.
While MA is not Medicare dental coverage so to speak, it is a benefit found in some Medicare Advantage plans.
Be sure to look at the extent of the dental coverage though. Don’t assume anything. It may not be the best by any means. 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 of these tend to deteriorate with age and qualified care is often needed.
Until the government takes some real action (don’t hold your breath), taking steps to resolve your dental coverage needs might make some sense.
On the plus side, many Medicare Advantage plans include dental coverage as part of the program. Be sure to verify the limitations though.
Though Part C of Medicare is called “Medicare Advantage” is a private program, Medicare itself does not approve the healtcare claims or treatments. Why?
It is not Original Medicare (Part A, Part B) which is a federal program.
You cannot just add Part C to get dental coverage.
It is one or other.
So, as a senior, the choices you have…either your on Original Medicare which offers full control of your healthcare providers or a private network (PPO, HMO) managed by a for profit insurance company such as Human, United Health Care etc. This is NOT Medicare Supplementation.
If you are on Original Medicare (largest majority of 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 dental services are covered in your Medicare Advantage plan?
Does it provide other valuable services like Vision and Hearing in the coverage?
What Can I Do About It? I’m On A Fixed Income.
The Best Dental Insurance For Seniors On Medicare
Quality senior dental insurance will deliver extensive coverage you can use for cleanings, fillings, x-rays, crowns etc. Consider looking for a policy that covers: preventive services, basic services and major services as well.
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 covered especially if you have had your share of dental problems in the past.
A good senior plan will not discriminate on your dental history or the provider you would like to go to.
In summary, you have a couple of different options to obtain the best dental insurance plans 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. Which one is best for you is going to be tied directly to your healthcare values and financial position.
In terms of the best dental insurance for seniors, we utilize 3 typical carriers. How ever, it really depends upon what you want from your coverage.
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?
The Next Steps
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.
An 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, you don’t let your dental health go down the tubes.
You can still obtain very good senior dental insurance outside your Medicare plan that even includes vision and hearing coverage.
Check with us regarding the options in your state. Not all policies are available in every state.
Unless you have very deep pockets, the first step to managing the cost of obtaining the best dental insurance for you as a senior is making sure you are not being overcharged on other insurance. Examine what you are paying for your insurance portfolio. Homeowners or renters, automobile and even your health insurance.
Do you have a Medicare Supplement insurance plan? What plan letter is it? When was the last time a professional shopped it for you?
Of course, if you don’t have a Medigap plan, none of this is relevant to you so you may disregard my coaching here.
Our experience for roughly 20 years…
We see seniors being taken advantage of all the time on Medigap plans. The sales person who sold it to them worked for one company or the policy owner was bought it when they turned 65 and have stuck with it for years. If this is your case you are likely overpaying.
There are cases where a seniors health is very, very poor that they cannot make a change to a more affordable carrier, but that is less common than you would think.
Most seniors we work with are on a fixed income. Are you in that situation yourself? Can you afford to pay hundreds of extra dollars a year for the same thing? This is a simple way of funding a good dental plan that even includes vision and hearing!!
Would you pay 20 cents more per gallon at the Shell gas station versus the Marathon a mile down the road? It is the same quality gas going in the tank after all.
Don’t be caught up in the hype of one company pays better than another. The Federal and state government mandates the performance of the standardized supplemental plans.
Buying into hogwash 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. Managing your costs of insurance is important. This is business. Insurance companies do not reward loyalty folks.
The best senior dental insurance policy is just another monthly cost on top of a non competitive Medigap plan.
Truth is, if you didn’t purchase any Medigap coverage thru an independent agent, you are likely losing a lot of money a year… thousands over a few years. That is how bad it gets.
Find a independent professional who can run your plan with all the top carriers to see who will save you the money to easily pay for your dental insurance you desire.
A good independent can also quickly shop out your coverage needs to see who the offers the best rates in the state for both dental, vision, hearing insurance and Medicare Supplemental plans.
There is not uncommon to have the best dental insurance for seniors in your portfolio and actually save money on your insurance each and every year.
The goal is to save you enough money to pick 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.
There are excellent dental options for seniors are out there right now.
No, these are not Medicare dental plans.
These are from private insurers.
Now that you have buttoned down the cost of your supplemental insurance, it is time to approach buying the best dental insurance.
The best plans for a senior citizen should ideally include vision and hearing coverage as well in one tidy, affordable policy. This will allow you to use your yearly benefits among all 3.
Remember, Original Medicare is not going to pay for any of these services.
Top senior dental policies certainly complement Original Medicare where it is lacking while rounding out your retirement healthcare benefits.
You should be able to see any dental, vision or hearing provider of your choosing with a top insurance policy. We see no reason why not to recommend otherwise.
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 your insurance costs. Affordable Dental insurance for seniors is an option you can look into.
We have complete solutions here at Maple Valley Insurance Group. Contact Us @ 269-244-3420 to see how we can help you solve your dental insurance need and save money.
No more worries about big dental bills, the ever increasing costs of getting new glasses and coverage for a hearing aid and testing.
If you have questions or comments about this article, feel free to leave it below. We try to respond as quickly as possible.