Randol Mill Family Dentistry
1115 Randol Mill Road, Suite 100, Arlington, TX 76012
Most senior citizens have Medicare as their medical insurance and Medicare does not cover dental costs. When individuals turn 65 and start collecting Social Security, they are automatically enrolled. Some younger people with long-term disabilities also are eligible to collect Medicare. The only way Medicare will pay for dental care is if it is medically necessary. For example, Medicare may pay for a dental exam before an organ transplant. The list of allowed dental coverage is extremely limited under Original Medicare.
Seniors options include Medicare Advantage, standalone dental insurance or a dental discount plan. It’s essential for people over age 65 to have dental benefits in Arlington since an unhealthy mouth can increase a person’s risk of developing serious medical conditions such as strokes or heart disease. There is also no age limit for wanting an attractive smile that allows a person to speak and eat comfortably.
In light of the fact that seniors spent over $28 billion in 2016 on dental care, it’s vital that they have access to better dental care. Every day, 10,000 people turn 65, making dental benefits for seniors a growing issue since older people are more affected by poor oral health than their younger counterparts. Some seniors believe that if they don’t have teeth left, they don’t need to visit a dentist. This is a myth; people without teeth still need oral exams. They are needed also to care for dentures as they can become ill-fitting over time and they will need replacing.
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.
Private, Medicare-approved companies offer Medicare Advantage plans, also called Medicare Part C. Medicare Parts A and B beneficiaries are eligible to choose a Medicare Advantage (Medicare Advantage) plan which will cover the expense of administering your dental benefits as Medicare pays them a lump sum to do so. Many Medicare Advantage plans offer supplemental benefits, such as gym memberships, basic dental, hearing and vision coverage, although the amount of coverage varies. About one-third of Medicare beneficiaries receive their benefits through Medicare Advantage plans. Popular Medicare Advantage plans include Aetna, Humana, UnitedHealthCare and Blue Cross Blue Shield Affiliates.
Since private companies offer Medicare Advantage plans, out-of-pocket costs and benefits offered vary greatly. Among Medicare Advantage plans, dental coverage can differ as well. Most of the plans which offer dental coverage include preventative care. Others offer coverage for fillings, extractions, dentures and more. According to AARP, Medicare Advantage plans with dental benefits differ widely between states. Florida residents have a larger variety of plans available to them offering dental benefits while in New Hampshire, only one in three plans offer dental benefits.
If you want to purchase dental insurance, you’ll have an almost overwhelming number of options. HMO plans are ideal for seniors who are looking for affordable coverage. If you choose an HMO dental plan, you must visit an in-network dental provider. PPO plans have higher premiums; however, you can visit an out-of-network provider, but you’ll have less coverage. Dental indemnity plans let you see any dentist, but they have higher premiums and copays. Be sure to confirm if there is a maximum amount of coverage per year. Inexpensive policies can limit you to $500 to $1,000 per year of benefits. If you expect to need a lot of work, consider paying higher premiums for a higher annual limit.
Most insurance companies divide care into different types. You have preventative care, such as routine exams, will even the most basic plans usually cover. Basic restorative care is fillings and other procedures to preserve a tooth, such as a root canal. Crowns and bridges are major restorative procedures. Orthodontic work is usually a separate class. Dental PPO plans usually use the 100/80/50. They pay 100 percent of preventive services, 80 percent of basic restorative services and 50 percent of major restorative procedures. Dental HMOs typically have members make specific co-payments to dentists instead of paying a percentage.
When you buy insurance, there’s typically a waiting period before you’re covered, except for preventative care and basic restorations. If you need a crown or a bridge, you may have to wait six months before your coverage kicks in. This is to protect insurance companies from people who wait until they need a major procedure before buying a policy. Most plans don’t cover dental problems, like a missing tooth, which you had prior to buying the insurance.
Many seniors are unfamiliar with the benefits of using a discount dental plan. This is unfortunate because cost is the biggest obstacle seniors cite for not seeing a dentist. When you become a member of a discount dental plan, you carry a card with you to show at a participating dental office. Your annual membership fee entitles you to discounts on nearly all the services the dentist provides. Typical covered services include:
Before selecting a plan, review the procedures offered at discounted rates to ensure there are discounts you will probably use. Many discount dental plans also include vision and hearing care discounts as well. For example, DentRite® offers discounts on eye exams, eyeglasses, contact lenses and vision correction. These are services important to many seniors. While some Medicare Advantage plans also have these benefits, they usually do not provide these levels of savings.
Discount dental plans are affordable, costing around a couple hundred dollars per year on average. There are other reasons why seniors may want to consider a discount plan instead of insurance:
Seniors who buy insurance because they are worried about large dental bills should prioritize preventative care, such as an exam every six months. Preventative care is usually covered 100 percent and fillings at 80 percent. Neglecting regular checkups will let small, relatively inexpensive problems turn into expensive, difficult-to-treat problems which require a larger co-pay.
Seniors who have difficulty paying a large copay or dental expense can ask their dentist if they offer payment plans or if they can suggest a lower-priced treatment option. Applying for a medical credit card, such as CareCredit, is also an option. You can apply over the phone and take advantage of promotional offers with no interest for several months. Depending on how good a person’s credit is, the promotional periods can run from six, 12, 18 or 24 months. The drawbacks are that you may not be approved or you not not get the balance paid off before you’re charged interest. The normal interest rate may be anywhere between 15 and 20 percent.
Senior organizations, such as AARP, may have information about discounts and other dental benefits in Arlington. Professional organizations and AAA may also be a good source of discounts.