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A Senior’s Guide to Dental Benefits and Medicare Advantage in Fairfax Corner
In addition to routine maintenance, seniors often need dental procedures to correct issues caused by age, dental neglect, or chronic health conditions. Sadly, seniors are also the group most likely to go without dental benefits. Despite the fact that two-thirds of seniors go without basic dental coverage, seniors spend more than $28 billion per year on dental services. With the number of seniors visiting a dentist increasing by more than 6 million between 2006 and 2016, seniors had the highest growth rate of dental spending of any demographic group. There is also no sign that this trend will change any time soon.
Going without dental benefits in Fairfax Corner can end up costing you more in the long run than a Medicare Advantage plan, private dental insurance, or discount plan. The cost of common dental services can vary widely based on your location, the type of services, the complexity of your dental issue, and the skill and experience of the dentist. The following is an overview of what you might pay for common procedures without dental benefits in Fairfax Corner:
Checkups and Cleanings:
- Basic exam–$50 to $100
- Dental X-ray–$20 to $250
- Standard cleaning–$70 to $200
- Silver amalgam–$50 to $300
- Composite–$90 to $450
- 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
The cost of a crown can range from $500 to $3,000 based on the type of material used.
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 Alternatives Do I Have for Dental Benefits in Fairfax Corner?
Those of us who get our dental benefits through our employer tend to give little thought to the fact that those benefits end once we leave the workforce. Many seniors are also shocked to find out that Medicare does not include routine dental benefits. Medicare Part A will only cover a basic exam under limited circumstances, such as when it is required for presurgical clearance for a covered procedure. Sadly, 65% of seniors do not have any type of dental benefits. This percentage is expected to increase in the near future since 10,000 baby boomers turn 65 every day. About one-quarter of seniors receive some coverage through a Medicare Advantage supplement. Approximately 10% of seniors opt to purchase comprehensive coverage through a private insurer.
Do Medicare Advantage Plans Cover Dental Expenses?
Medicare supplement plans, which augment the benefits offered by traditional Medicare, are an affordable way to get dental coverage. These plans are offered by private insurers, such as Humana, Aetna, and UHC, so you will receive a separate ID card in addition to the red, white, and blue Medicare ID card. Instead of the government reimbursing providers for their services, the benefits covered by Medicare supplements are reimbursed directly by the insurer. There are several reasons to consider purchasing a Medicare supplement plan:
- The average premium is around $420 per year, which is relatively affordable.
- Most plans offer price protection, such as limits on out-of-pocket expenses and low deductibles.
- You get access to a qualified network of providers.
- Most supplement plans offer benefits for hearing, vision, prescription drugs, and dental services.
Since the dental benefits included in most Medicare supplements are limited to basic exams, cleanings, and X-rays, you can still face significant out-of-pocket expenses if you need advanced treatments or procedures.
When Does It Make Sense to Purchase Standalone Dental Insurance?
Private dental insurance is one of the best ways to get comprehensive dental coverage. For an average cost of $350 per year, most standalone dental insurance plans will cover anywhere from 50% to 100% of the cost of common dental procedures. Since most companies offer multiple levels of dental plans, you can customize your coverage options and premiums to your needs and budget.
Basic Dental Plans:
If you are in good oral health and just need coverage for routine maintenance, a basic dental plan may be right for you. These plans normally cover prophylactic services, such as exams, cleanings, and routine X-rays.
Mid-Level Dental Plans:
If you are looking for expanded coverage at a price that is still relatively economical, you may want to consider a mid-level dental plan. These plans normally cover specialized X-rays, dentures, fillings, orthodontics, emergency services, and inhalation anesthesia.
Premium Dental Plans:
Premium dental plans offer comprehensive coverage for advanced services, such as restorations, endodontic and periodontic procedures, oral surgery, and full or partial dentures. While these plans may be overkill for individuals who are in good oral health, they drastically reduce the out-of-pocket expenses for individuals with significant oral health issues.
One downside of standalone dental plans is that they do not offer the vision, hearing, and prescription benefits found with Medicare Advantage plans.
What Are the Pros and Cons of Dental Discount Plans for Dental Care?
Various health and wellness discount plans have become a popular alternative to traditional insurance in recent years. Discount plans are sold by private companies that have negotiated discounted rates for basic services with participating providers. Instead of a monthly or yearly premium, plan members pay a low enrollment fee and a small monthly or yearly membership fee. Plan members then pay the provider directly for covered services at a discounted rate. Discount plans, such as DentRite®, do have features that you won’t find with traditional insurance. For example,
- You are free to change providers at any time. You can even use your benefits out of town as long as the provider accepts the plan.
- There are no waiting periods, so you can use your full benefits right away.
- You don’t have to pay deductibles, fees for office visits, or coinsurance.
- You can visit the dentist as many times as you want during the year.
- You cannot be denied because of your age or preexisting conditions.
- The discount is automatic, so you don’t waste time filling out paperwork.
- You can get a full refund minus a small processing fee if you cancel within 30 days.
- You can include family members on your plan.
- Most discount plans also provide discounts for prescriptions as well as hearing and vision services.
Discount plans do not cover quite as much as traditional insurance, but they do reduce the cost of common procedures anywhere from 20% to 80%. Covered procedures typically include crowns, fillings, basic exams, routine cleanings, dentures, extractions, root canals, and X-rays.
These plans work well for individuals who primarily need only routine maintenance or the occasional minor dental procedure. Standalone insurance may still save you more money if you need extensive dental work.
Does It Make Sense to Finance Dental Care?
A number of medical and dental practices now offer payment and financing options. CareCredit is one such financing option. Accepted by more than 200,000 health and wellness facilities and providers across the nation, CareCredit offers short-term and long-term financing ranging from two years to five years based on the amount owed. There are several things to keep in mind when financing dental services:
- You do need to meet credit criteria, which means that you may not qualify if your credit history is marginal.
- You can expect to pay interest rates ranging from 15% to 20%, which drastically increases your overall cost.
- If you qualify for a no-interest promotion, it is important to pay off the entire balance by the end of the promotional period. If you don’t, all of the interest that you would have been charged will be added to your balance.
Senior advocacy organizations, such as AARP, have resources for seniors looking for more information on insurance options or discounts for professional services.