Dentistry is an often ignored aspect of our health. But did you know that your oral health can directly impact the rest of your body? In fact, according to the American Heart Association, about 50% of all heart attacks and strokes are triggered by oral pathogens. In addition, certain oral conditions increase our risk for Alzheimer’s disease and several forms of oral cancer.
Unfortunately, routine and restorative dental care is not covered by Original Medicare (Parts A and B). Therefore, if you are enrolled in Original Medicare, with or without a Medicare Supplement plan, it’s important that you also enroll in some form of dental insurance. Fortunately, there are quite a few options, and many people find the options are budget-friendly.
Today, we’ll discuss five ways to get insurance coverage for your dental care.
Original Medicare also does not include benefits for routine vision and hearing services. For example, there is no coverage for eyeglasses, contact lenses, or hearing aids. Because of that, many companies offer an all-in-one solution to the three areas not included in Medicare coverage.
Many private insurance carriers offer DVH plans, so their benefits and premiums vary. In most cases, the dental portion is what makes up the “bulk” of the benefits and is the driving factor behind their purchase. Most carriers allow you to customize the dental benefits by choosing your deductible and annual maximum. (The deductible is the amount you must pay before insurance begins, and the annual maximum is the maximum amount the carrier will pay for claims.)
In some cases, there will be an additional premium to add riders for vision and hearing coverage, while other plans include both benefits in their base premium.
Medicare beneficiaries can also purchase stand-alone dental plans without the additional vision and hearing benefits. These plans work similarly to the DVH option. In either case, there are several things you should consider.
First the coverage itself. Dental services are divided into three main categories: preventive, basic, and major. Preventive services include cleanings, exams, and x-rays. Basic services often include fillings, tooth extractions, and sometimes root canal treatment. Major services include crowns, bridges, and dentures. Each plan will cover these services at a certain percentage. For example, many policies cover preventive care at 100%, basic at 80% and major at 50%. However, be sure to check the summary of benefits as plans often vary significantly. This is the first aspect to compare when looking at multiple plans.
Second, consider the deductible and annual maximum. Deductibles range from $0 to $100 per year. Annual maximums range from approximately $1,000 to $5,000 per year. Of course, you’ll pay more for a higher maximum, but if you have current dental concerns or often find yourself getting dental treatment, it may be wise to opt for a higher maximum.
Third, ask about provider networks. Some plans only work within a certain network, like HMO (Health Maintenance Organization) plans. Others, like PPOs (Preferred Provider Organizations), have out-of-network benefits. It’s important to know where you can use the plan you choose.
Lastly, compare premiums. Once you know what kind of benefits you’re looking for, compare premiums from multiple carriers to ensure you find a competitive rate.
Dental discount plans are another option offered by private insurance companies. They are not insurance plans but discount plans only. If you enroll in the "ABC Dental Insurance" discount plan, you will receive discounted rates when you see a dentist that accepts that plan.
For example, if the dentist’s fee for a crown is $1,200, your discount plan may allow you a discount of $500. Like the other options we’ve discussed, plan details vary, and you should be sure there is a dentist in your area that accepts these plans before enrolling.
Another way to get dental coverage is by enrolling in Medicare Advantage. Not all Medicare Advantage plans include dental benefits, but some do. Again, be sure to review the provider networks within the plan, so you know if there are providers who are willing to accept this type of insurance.
In addition, you cannot have both a Medicare Supplement and Medicare Advantage plans. Both are great options but work quite differently. You should not consider enrolling in Medicare Advantage just because of the extra benefits.
One last option to reduce your dental expenses is with an in-office membership plan. Like the discount plans, these are not insurance and are unique to each dental practice. Most practices offer a monthly membership fee in exchange for reduced costs.
Your membership plan might include two cleanings per year, plus a discount on treatment. The disadvantage of in-office memberships is that they are not transferrable, and you cannot use them if you need to see another dental provider for care. For example, if your dentist refers you to an oral surgeon, the oral surgeon will not accept the membership plan.
If you’d like to learn more about Medicare dental plans in Arizona, give your Local Medicare Specialists a call! We can help you decide how much coverage you might need and shop for plans that meet those needs. There is no cost to use our services, so call today!
Schedule a FREE Medicare consultation with an agent in your neighborhood.