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Did you know that seniors over the age of 65 are often those who need dental care the most? Despite this fact, seniors also have the most limited access to affordable dental services, putting them at risk of developing dental health problems. This lack of care is usually due to lack of insurance coverage, as most people receive dental insurance through employer-based plans. Seniors seeking dental benefits in Fort Lauderdale must explore other options once they retire from the workforce. However, nearly 65% of seniors go without dental coverage entirely, and the number of uninsured seniors is only going to rise since more and more people reach age 65 each day.
Even though many seniors lack insurance, spending on dental care is still increasing. In 2016, seniors spent over $28 billion on dentistry — the highest growth rate in dental spending among all population segments. The American Dental Association Health Policy Institute reported that 6 million more seniors went to the dentist in 2016 than a decade ago, and that number should increase over time. While spending is up, nearly half of the individuals receiving Medicare had not seen a dentist over the past 12 months. Additionally, 19 percent of Medicare recipients who did see a dentist spent over $1,000 out of pocket. The list below outlines some common costs of dental procedures:
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.
Do Seniors Have Choices for Dental Insurance?
If you’re over the age of 65 or are permanently disabled, Medicare is available for healthcare coverage. All seniors are enrolled in traditional Medicare after they reach age 65. Traditional Medicare participants receive a red, white and blue ID card and do not receive dental insurnace benefits in Fort Lauderdale for routine dental exams and cleanings as well as common procedures like extractions and fillings. However, some dental services may be covered by Part A hospital benefits if they are a necessary part of another covered procedure. One example is a dental exam that’s needed to clear a patient for surgery. This often leaves Medicare beneficiaries looking for other ways to pay for dental costs. Ten percent of these beneficiaries turn to private insurers, while a quarter of them will enroll in Medicare Advantage plans to supplement their existing benefits.
How Does a Medicare Advantage Plan Work?
A Medicare Advantage supplement is an optional plan provided by a private insurer that expands the benefits offered by traditional Medicare. These plans offer seniors access to a network of qualified healthcare providers as well as some price protection. Out-of-pocket spending limits, lower deductibles, and cost-sharing measures are all benefits of this type of plan. Medicare Advantage plans are different from traditional Medicare in that all costs are reimbursed by the insurer instead of the government. In addition to general medical care, these plans often include dental benefits, vision services, and coverage for prescriptions. Some of the most popular providers include Aetna, Humana, and UHC.
If you choose a Medicare supplement plan, your insurer likely will give you a separate ID card. Typically, you’ll also enjoy lower premiums, making the plans an excellent option for seniors on fixed incomes. However, dental benefits are usually limited to routine exams and preventive care like cleanings and X-rays.
Should I Choose Standalone Dental Insurance?
Those desiring more comprehensive dental benefits in Fort Lauderdale may wish to consider a standalone dental plan. These are offered by private insurance companies and usually have several levels of coverage at different prices. Premiums, what services are covered, and the percentage of cost covered will vary depending on what option you choose. Here are some examples of standalone insurance plans:
Basic: Basic plans usually cover oral evaluations, professional cleanings, and prophylactic services. They also cover diagnostic X-rays.
Mid-level: Patients will receive expanded services under a mid-level plan, including orthodontic care, emergency dentistry, specialized X-rays (including panoramic X-rays), inhalation sedation through nitrous oxide, fillings, and dentures.
Premium: With a premium plan, you’ll receive at least partial coverage for more advanced dental procedures. This type of plan is ideal for those with ongoing dental health issues. Some of the services covered by premium plans include:
- Dental crowns
- Inlays and onlays
- Endodontic procedures
- Oral surgeries
- Complete and partial dentures
- Periodontal treatment
Many private dental plans provide tiered coverage, sometimes referred to as “100-80-50.” With this type of coverage, routine exams are fully covered at 100%, basic procedures receive 80%, and complicated procedures are covered at 50%. Research from Bankrate shows that the average cost of private dental plans was around $350 in 2017. While this can be lower than Medicare Advantage premiums, you will not have the additional vision, prescription drug, and hearing benefits with a private plan.
Can Dental Discount Plans Be a Good Option for Those Without Insurance?
A dental discount plan is sold by a private company, but it’s important to note that they are not insurance. Providers that accept discount plans agree to accept lower rates for basic services, such as routine dental exams. Instead of paying premiums monthly or yearly, the patient will pay an enrollment fee for the plan as well as a low monthly membership fee. The patient also will pay the dentist directly at the practice at a pre-negotiated discount rate.
Most discount plans are quite affordable. Additionally, they offer several key advantages over private insurance:
- Discount plans have no coinsurance requirements, deductibles, or copays.
- There is no waiting period before you can receive full benefits.
- You can visit the dentist as often as you need to – there are no limits.
- You can switch dental offices at any time.
- There are no claim forms or paperwork to fill out, making trips to the dentist less stressful.
- Unlike private insurance, discount plans do not have exclusions for preexisting conditions or age limits — any patient can join.
While a discount plan may not cover as many services as a traditional insurance plan, they can provide significant savings on routine services. Some of the services include:
- Dental checkups
- Professional cleanings
- Tooth extractions
- Root canal therapy
Many popular discount plans, including DentRite, offer savings on vision and hearing services as well as prescription drugs. Getting a discount plan may be a great option if you are in generally good oral health and will only require maintenance services. However, if you require extensive dental treatment, you may wish to choose a standalone dental insurance plan in order to save money.
How Can You Manage Out-of-Pocket Dental Expenses?
Flexible payment options and financing options are one way dental providers can help patients manage out-of-pocket expenses. One option is CareCredit, which is available at more than 200,000 health and wellness providers nationwide. Typically, medical credit companies provide short-term financing for up to two years interest-free if the balance is paid in full by the end of the promotional period. Long-term financing is also available for larger expenses. Keep in mind that financing your dental costs does have some disadvantages:
- As with a credit card or other form of credit, you’ll have to apply and be approved – not every patient will qualify.
- Interest rates can be around 15% to over 20%, adding to the total cost of care.
If you are searching for additional information on Medicare supplements, discount plans or other dental benefits in Fort Lauderdale, we recommend contacting AARP or other local senior organizations. These groups can be a valuable resource for seniors looking for affordable dentistry options.