Medicare Advantage dental benefits in McLean (Seniors 65+)

Despite the fact that they are one of the segments of the American population most in need of dental care, seniors over the age of 65 currently have the least access to affordable dental health care. This is due to a lack of insurance brought on by leaving the workforce at the age of retirement. Since most people in America receive their insurance through an employer, seniors are often left scrambling to find options that will help them to afford their dental health care once they have left the workforce. This leaves somewhere around 65% of seniors going without coverage for their dental needs. Since more than 10,000 people turn 65 in the United States every day, this means that the percentage of seniors without access to affordable oral health care will continue to grow.

In 2016, seniors spent over $28 billion on oral health care services. They also had the highest rate of growth in dental spending amongst every segment of the population of the United States. Studies indicate that in 2016, 6 million more seniors sought out dental health care than in 2006. Despite this growth rate, the Kaiser Family Foundation found that almost half of the people on Medicare hadn’t sought a dentist within the last year. Out of those who did, approximately 19% ended up paying over $1,000 out of pocket. Some examples of what common dental procedures can cost are included below.

Checkups and Cleanings:

• Basic exam–$50 to $100
• Dental X-ray–$20 to $250
• Standard cleaning–$70 to $200

Fillings:

• Silver amalgam–$50 to $300
• Composite–$90 to $450

Extractions:

• 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

Crowns:

The cost of a crown can range from $500 to $3,000 based on the type of material used.

Root Canals:

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.

What Choices Do Seniors Have for Dental Insurance Coverage?

Seniors on the hunt for dental benefits in McLean have several options available to them. On your 65th birthday, you will be enrolled in Medicare. Medicare is available to all Americans over the age of 65, as well as to those who are permanently disabled. Once you have received your red, white and blue identification card for traditional Medicare, you will be entitled to basic health care coverage. However, this coverage does not extend to basic dental care. While there are circumstances where dental services are covered under Part A hospital benefits, this does not happen often. This means that you will need to find other ways of paying for your dental health care. Some seniors choose to utilize private insurers, while others decide to enroll within a Medicare Advantage plan.

What Should I Know About Medicare Advantage Plans?

A Medicare Advantage plan is a supplemental add-on to traditional Medicare. These plans expand on the types of benefits provided by traditional Medicare by granting you access to a network of providers while also giving you price protection through out-of-pocket spending limits, cost-sharing measures and low deductibles. The primary difference between these plans and traditional Medicare is that in the case of traditional Medicare, the government reimburses the health care provider. Medicare Advantage plans consist of a private insurer such as Humana, Aetna or UHC reimbursing the health care provider instead. Once you have enrolled in one of these plans, you will receive an identification card from your insurance provider. These supplemental Medicare plans offer you low premiums, however your benefits are typically restricted to basic cleanings, exams and X-rays. Most people pay an average of $420 per year for a supplemental Medicare plan. In addition to providing you with dental benefits in McLean, you will also be given vision, hearing and prescription drug benefits.

What Should I Know About Standalone Dental Insurance?

Standalone dental insurance is another good option, especially for those seniors who are in need of comprehensive coverage. You can find plans at a variety of price points and levels of coverage. The percentage covered, the types of services covered and the premiums you will need to pay will depend on the type of plan you purchase from the insurer.

Basic Plans:

This type of plan generally includes basic examinations, cleanings, prophylactic services and standard X-rays.

Mid-level Plans:

A mid-level plan usually includes services like dentures, fillings, orthodontics, emergency treatments and specialized X-rays. Inhalation anesthesia is typically covered as well.

Premium Plans:

This type of plan tends to provide patients with at least partial coverage for extensive dental work. They are an excellent option for those who are in need of several different types of dental procedures. Some of the types of services provided by premium plans include:

• Inlays
• Onlays
• Crowns
• Endodontics
• Oral surgery
• Complete dentures
• Partial dentures
• Periodontics

Most private dental insurance plans cover routine examinations at 100%. Fillings and other types of basic services are covered at 80%. Complex procedures and services are typically covered at 50%. This is known as the “100-80-50” tiered coverage model. Most people will pay around $350 a year for their private dental plan. These plans do not include vision, hearing and prescription coverage like Medicare supplemental plans do.

How Do Dental Discount Plans Differ from Insurance?

While sold by private companies, a dental discount plan is not the same as insurance. Discount plans provide members with pre-negotiated rates on dental services for an enrollment fee and monthly payment. The plan provider negotiates with dental health care providers to determine a discounted rate for dental services. The patient then pays the dentist directly for the services that have been provided to them. A discount plan offers some advantages over insurance which include:

• Affordability
• There aren’t any deductibles, coinsurance obligations or copays.
• There aren’t any limits on the number of visits you can have every year.
• It’s easy to change your dentist at any time you want to.
• There aren’t any claim forms or paperwork to complete.
• Most plans don’t have exclusions for pre-existing conditions or age limits.

While utilizing a discount plan won’t provide you with as much coverage as a traditional insurance plan would, you will receive dental services at a substantially reduced rate. Services you can receive discounts on include:

• Cleanings
• X-rays
• Extractions
• Crowns
• Root canals
• Fillings
• Dentures

In addition to providing you with discounted dental health care, these discount plans often offer discounts on prescriptions and vision and hearing services. If you aren’t in need of extensive dental health care procedures, a dental discount plan may be a good option for you to pursue.

Are There Options for Managing Out-of-pocket Dental Expenses?

Even though you may already have dental benefits in McLean, you will probably have out-of-pocket expenses to worry about. Most providers of dental health care offer payment plans or financing options. A popular form of financing is CareCredit. This is a medical credit company that is accepted by over 200,000 health and wellness providers around the United States. You can receive short-term and long-term financing through companies like CareCredit. The downside to utilizing financing companies are that they require you to apply for and meet their requirements before you are approved. This means that there are many people who do not qualify for this type of financing. In addition, you can expect to pay high interest rates on your financing plan.

If you are interested in finding more information on how to save money on your dental health care needs as a senior, contact AARP or another senior organization. You can also contact our office to learn more about payment and insurance options for seniors.