How Seniors Can Get Dental Insurance Coverage

Dental Insurance Coverage for seniors

In the movie “Peggy Sue Got Married,” Peggy Sue goes back in time. Visiting her grandfather, she asks him what he would do differently if he could do one thing differently. Her grandfather says, “I’d have taken better care of my teeth.”

This is a common complaint people make as they age, as the body’s natural deterioration often leads to tooth loss. In addition, teeth lose some of their sensitivity, making it more difficult to recognize dental issues early, when they are easier to treat. Clearly, the need for regular oral care does not diminish with age.

Even though original Medicare does not include dental insurance coverage, there are options to help cover the cost of routine dental care.

Why Should You Buy Dental Insurance?

Most people receive no government assistance when it comes to dental care. What’s more, these programs typically only cover extractions. The problem here, of course, is that this ignores serious dental issues affecting older adults. For example, nearly a quarter of people over age 60 have none of their natural teeth, with over 40 percent of seniors wearing dentures or dental implants. Periodontal disease and tooth decay are the culprits, with around 23 percent of people between the ages of 65 and 74 suffering from severe periodontitis.

Over 400 prescription medications cause dry mouth, leading to increased risk of oral disease. In addition, over 30,000 people receive an oral cancer diagnosis each year.

The earlier you buy dental insurance, the better. If you wait until dental problems manifest, rates are higher. What’s more, insurers may refuse to provide coverage entirely.

Medicare Advantage

Some Medicare Advantage (Medicare Part C) plans include routine dental care. When choosing your plan, look carefully at coverage options, including items you may not need now, such as dentures.

Standalone Dental Plan

If you choose original Medicare, or your Medicare Advantage plan does not include dental coverage, a standalone dental plan may be your best bet. They work much the same way medical insurance works, with monthly premiums, co-pays, and in- or out-of-network requirements.

In general, dental insurance covers routine care, including:

  • Twice yearly cleanings and exams, typically with no out-of-pocket cost
  • Extractions, typically requiring a co-pay or deductible
  • Fillings for cavities and tooth decay, typically requiring a co-pay or deductible
  • X-rays, with a possible co-pay or deductible

Not all dental plans include coverage for repairs such as bridges, crowns, and root canals, and those that do typically only cover up to 50 percent.

Dental Savings or Discount Plans

Note that Dental Savings and Dental Discount plans are not dental insurance. Instead, they mimic a grocery club membership. The discount plan includes a certain group of dental providers, and you pay a fee (either monthly or yearly). When you visit one of these dentists, you show your membership card and receive a discount off the dentist’s standard rate.

Additional Tips

Just as with health insurance, there is great power in being an informed consumer. Take the time to perform your research, comparing plans, coverage, premiums, and providers. For example, if you have a long-standing relationship with a dentist, ask whether he or she accepts the plan you prefer.

When looking for a dentist, do not be afraid to ask for a list of fees, including charges for exams, cleanings, and x-rays. If considering one of the savings or discount plans, ask the provider what discount he or she offers. Even within the same plan, dentists offer varying discounts.

Finally, take advantage of the information provided online. A bit of time spent researching ensures you get the best plan to fit your budget.