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Should Seniors Purchase Dental Insurance?

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The older we get, the more we have to baby our teeth. Seniors are often faced with a myriad of dental issues – from dry mouth to dental decay – that can take a toll on your health and your smile. 

The good news is that modern dentistry can keep our teeth and gums healthy throughout our lives. The bad news is that we’ll probably be paying for that dental care out-of-pocket. Most of the traditional medical insurance options that specifically serve seniors, like Medicare, do not cover regular preventive or restorative dental care. Thankfully, there are solutions, such as dental savings plans, that can reduce the cost of dental treatments. 

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Medicare and dental insurance 

Medicare does not cover dental unless dental treatment is required as part of a medical procedure. And even then, Medicare will only cover exactly what you need medically and no more. For example, if you need a tooth extracted, Medicare will pay for the extraction but not for a replacement tooth. Or, if you need complicated oral surgery, Medicare may cover the surgical part of the procedure but will not cover the actual dental care. 

Medicare does cover: 

  • Dental exams as part of the standard medical protocol for kidney transplant or heart valve replacement procedures. 
  • Dental treatment as required for a disease that involves your jaw (such as oral cancer) 
  • Treatment for fracture of the jaw or (potentially) other facial bones. 
  • Severe dental infection that requires hospitalization 
  • Dental procedures that must be conducted in the hospital due to a life-threatening medical condition 

Also be aware that in many cases, Medicare will cover the costs of in-patient hospital care only, not the costs of the actual dental procedure. 

Medigap and dental coverage 

Medigap is supplementary insurance that you can purchase to cover your annual Medicare deductible and copayments/coinsurance costs. Medigap also covers health care costs when traveling outside of the U.S. 

But, just like Medicare, Medigap plans only pay for dental when your dental care and medical needs intersect. And – again just like Medicare – the coverage will typically only pay for the non-dental portions of your treatment. 

For details on Medicare and Medigap coverage, you can visit Medicare’s website, or call 1-800-MEDICARE (1-800-633-4227). If you are enrolled in Medicare, you can also log into your MyMedicare account. 

Dental insurance through Medicare Advantage  

Medicare Advantage Plans are provided by private companies that have been approved by Medicare. These plans must provide all of the services that Original Medicare covers except hospice care. Medicare Advantage Plans also typically include coverage for issues that Medicare does not cover, such as dental care, via a dental insurance plan. You should check the insurance plan’s details to make sure that the coverage meets your needs – it may focus on preventive care only. Also check the plan’s annual spending limit (usually $1000-$1500). If you exceed the limit, you need to pay out-of-pocket for your dental care until your plan resets. 

You pay a monthly premium for a Medicare Advantage Plan, which varies depending on the coverage offered. You can compare Medicare Advantage plan benefits and costs here. You can check to see if the plan offers dental (as well as hearing and/or vision benefits), by looking for colored circles marked with D, H or V.  

Should seniors purchase dental insurance? 

You can, of course, simply purchase a dental insurance plan directly from an insurance agent. You’ll likely get a better deal if you can join a group plan, so you may want to see if any of the associations you belong to offer dental insurance to members. 

But before you choose dental insurance, consider your dental care needs to ensure it’s right for you. 

Dental insurance typically has an annual spending limit of $1000-$1500. That’s the limit your plan will pay every year for your coverage. After that, you pay out-of-pocket for dental care. $1500 may seem like a lot, but if you need a single root canal and crown, you’ll likely spend your maximum on getting those two treatments alone. And you’ll quickly exceed your insurance coverage if you need a bridge, dental implants or dentures. 

Plus, there may be a waiting period before your coverage kicks in for the pricier dental procedures, such as dental crowns, bridges or dentures. This means you may only be covered for things like checkups, cavity fillings, and the most basic restorative care for 6 months to a year after joining a dental insurance plan. And most plans will never cover treatment for dental issues that you had prior to purchasing the plan. 

When you factor in such restrictions, you may decide that dental insurance isn’t the best choice for you. Personal Financial expert, Suze Orman suggests that seniors join a dental savings plan. 

Dental savings plans vs dental insurance for seniors 

Dental savings plans are the trusted alternative to dental insurance. Plan members report an average savings of 50%* on their dental care. Dental savings plans, unlike traditional dental insurance, do not have deductibles, waiting periods, paperwork hassles or annual spending limits. And you can save on treatment for dental troubles that you had before joining a plan. 

Dental savings plans are easy to use. You simply pay the reduced fee to any participating dentist nationwide whenever you get treatment. You can use your plan as often as you wish. Everyone qualifies for a dental savings plan. And there are no age or health restrictions.  

At DentalPlans.com, we’re here to help you find the dental plan that gets you the best care, at the best value – whether that’s a dental savings plan or insurance. Give us a call at 1-833-735-0399 and we’ll help you sort through the options, or you can use our calculator below to see your savings right now. 

* Discount Health Program consumer & provider surveys indicate average savings of 50%. Savings may vary by provider, location, and plan. 

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