Medicare Advantage dental benefits in VA (Seniors 65+)

As a senior over the age of 65, you are probably well aware of the importance of receiving regular dental care. However, this portion of the population is also the most likely to not have access to affordable dental health care due to a lack of insurance options. This is because most Americans receive dental and medical insurance via employer-sponsored plans. This leads to many seniors losing their coverage once they have retired. It also means that nearly 65% of seniors go without any kind of dental coverage. With more than 10,000 Americans turning 65 every day, this rate is only going to go up.

According to a study conducted by the American Dental Association Health Policy Institute, the year 2016 saw 6 million more seniors visiting a dentist than in the year 2006. The rapid growth seen within those ten years is expected to continue. Although more seniors saw a dentist, a second study conducted by the Kaiser Family Foundation discovered that almost half of Medicare beneficiaries had not visited the dentist in the previous year. Those that did paid more than $1,000 out of pocket. In 2016, seniors paid over $28 billion for dental health care. That same year also found that seniors had the highest rate of growth in dental spending. Examples of what common dental procedures cost can be found 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.

We know it can be daunting to look for dental insurance while on a limited or fixed budget. For more information about affordable dental insurance, keep reading or call our office in VA today. 

What Do Seniors Need to Know About Dental Insurance Options?

On your 65th birthday you will be automatically enrolled in traditional Medicare. Anyone over the age of 65 or anyone deemed to be permanently disabled are entitled to medical coverage via Medicare featuring the red, white and blue ID card. However, receiving Medicare does not entitle you to receive dental benefits in VA. Traditional Medicare does not provide you with coverage for routine dental services like extractions, cleanings and fillings. There are circumstances where you may have dental services covered under Part A hospital benefits. These circumstances only exist when the services are considered to be a necessary part of another medical procedure. The lack of dental coverage leaves those on Medicare looking for other ways to pay for their dental expenses. Some seniors turn to private insurance companies while others enroll in supplemental Medicare plans.

Can You Tell Me About Medicare Advantage Plans?

Medicare Advantage plans are optional supplemental plans that you may buy in order to expand upon the benefits you are entitled to under traditional Medicare. These plans will allow you to seek out care from a network of providers while ensuring that you also have out-of-pocket spending limits, cost-sharing measures and low deductibles. While regular Medicare plans involve the government reimbursing health care providers, the benefits provided to you under supplemental Medicare involve private insurance companies reimbursing health care providers. These plans are available for purchase from insurers such as Humana, Aetna and UHC. Once you have signed up for your Medicare Advantage plan, you will receive a separate insurance card from your chosen provider. Your premiums will most likely be low, making the plans very affordable for seniors. While the plans are affordable, it is important that you understand that you will most likely be limited to basic services such as regular X-rays, cleanings and exams. MedcareAdvantage.com found that most seniors paid approximately $420 per year for their Medicare Advantage plan in the year 2018.

Should I Consider Standalone Dental Insurance?

If you are seeking out a more comprehensive approach to dental benefits in VA, you may want to look into purchasing standalone dental insurance. Insurance companies all over the United States provide different levels of coverage at an array of price points. Your premiums, the percentages of your bill that will be covered and the kinds of procedures included will all depend on the plan that you choose.

Basic Plans:

Patients who utilize basic plans are frequently provided with coverage for oral exams, cleanings and prophylactic services and general X-rays.

Mid-level Plans:

Mid-level plans provide patients with coverage for orthodontics, specialized X-rays, emergency treatments, dentures, fillings and inhalation anesthesia.

Premium Plans:

For those on the hunt for at least partial coverage for more advanced procedures, premium plans are the way to go. These plans are best for those who are in need of significant dental work. Premium plans frequently provide coverage for:

• Onlays and inlays
• Crowns
• Oral surgery
• Endodontics
• Periodontics
• Partial and complete dentures

In most cases, private dental insurance is provided with in the following form: “100-80-50” coverage. This means that services are covered based on a tier. Routine dental exams are typically covered at 100%, while fillings and other basic services are offered at 80% and advanced procedures are provided at 50%. The average amount that a private insurance plan costs is around $350 a year. While this does cost less than a supplemental Medicare plan, you should keep in mind that it does not include coverage for hearing, vision and prescriptions like supplemental Medicare plans have.

Should I Enroll in a Dental Discount Plan?

Dental discount plans can be a viable option for affording dental health care. Sold by private companies, these types of plans are not dental health care insurance. A dental discount plan consists of the patient paying an enrollment fee and monthly membership fee in exchange for a pre-arranged discount on dental services. If you opt for a discount plan, you will pay your dentist directly.

Discount plans are typically affordable. They offer some benefits that insurance does not offer. These benefits are:

• The ability to change your dentist whenever you want.
• No paperwork or claim forms that need to be filled out.
• Not having to deal with deductibles, coinsurance or copays.
• A lack of waiting periods before you can utilize all of your benefits.
• No limitations on the number of times you can see a dentist each year.
• No age limits or pre-existing condition exclusions.

A dental discount plan usually does not cover as much as a traditional insurance plan will. However, your costs will be lower for procedures like:

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

Many discount plans also bring you discounts on vision, hearing and prescription drug services. If you only need regular cleanings and other basic forms of dental health care, a dental discount plan may be the right choice for you.

Are There Payment Options Available for My Larger Dental Expenses?

Many seniors who are looking for dental benefits in VA have concerns over the costs of their dental care. This concern is understandable. Luckily, a great number of dentists in the area offer payment plans and accept a variety of financing options. Many people utilize a financing option known as CareCredit. This financing plan is accepted at more than 200,000 medical care providers around America. Medical credit companies, such as CareCredit, provide patients with the option of utilizing short-term financing or long-term financing. If you pay off your bill before the promotional period is up, you will typically not have to pay any interest. Financing does come with some downsides. These include:

• The fact that not everyone will qualify for these finance options.
• Interest rates can range from 15% to over 20%. This makes the overall cost of care more expensive.

If you would like more information on how to receive discounts on dental services or insurance coverage, you might want to check with AARP and other types of senior organizations. Typically, they can provide guidance on a variety of options. Feel free to call us for more information as well.