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Understanding Medicare Advantage in Northern Virginia and Dental Benefits for Seniors
Because of age, chronic health conditions, and other factors, seniors are at greater risk for various dental issues. Unfortunately, seniors also have the fewest options for affordable insurance and dental benefits. Even though two-thirds of seniors don’t have dental coverage, an American Dental Association Health Policy Institute report found that they still spent approximately $28 billion on dental services in 2016 alone. In fact, the number of senior adults visiting the dentist during the year increased by 6 million during the decade between 2006 and 2016. The growth rate of dental spending is higher among seniors than any other segment of the population, and this growth is expected to continue well into the future. The following are a few ways in which seniors can reduce the cost of essential dental services.
According to the Kaiser Family Foundation, only about half of Medicare recipients visit a dentist each year. Access to affordable dental insurance is one of the most common barriers to seniors receiving the dental treatment that they need. Without some form of dental benefits in Northern Virginia, even basic services can cost hundreds or thousands of dollars. The following provides a basic idea of what you can expect to pay out-of-pocket for common dental services:
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.
How Do I Get Dental Benefits in Northern Virginia?
Most of us receive low-cost dental benefits through our employer. This means that we must look for alternatives once we retire. To make the situation even more difficult, Medicare, which is the only source of health benefits for many seniors, does not provide benefits for routine dental services. The only dental benefits are under Medicare Part A, which only covers a basic exam when required for another covered procedure. This leaves 65% of seniors without any type of dental benefits. Approximately 25% of seniors purchase Medicare Advantage plans, which cover certain types of dental services. Only 10% of seniors have comprehensive coverage through a private dental insurer.
Can I Get Dental Care Benefits Through Medicare Advantage?
Most Medicare Advantage plans offer limited coverage for dental services, such as routine exams, cleanings, and X-rays. Medicare supplement plans are purchased from private insurers and offer benefits beyond those offered by basic Medicare. With a Medicare supplement, the health care provider is reimbursed by the insurer rather than the federal government. Some of the most popular Medicare supplement providers include UHC, Aetna, and Humana. If you enroll in one of these plans, you will receive the traditional red, white, and blue Medicare card as well as a separate ID card from your supplement provider. At an average cost of just over $400 per year, Medicare supplements fit within most budgets. In addition to the dental benefits, most plans also provide hearing, vision, prescription medication, and other health and wellness benefits.
How Do I Choose the Right Dental Insurance Plan?
When choosing a dental plan, you should consider the type of services and procedures covered by the plan, your dental history, and your budget. Most insurers offer several levels of plans with different benefits and price points.
Basic Dental Plans:
If cost is a major concern, basic dental plans are relatively inexpensive and provide coverage for maintenance and prophylactic services. Most basic plans cover routine exams, cleanings, and standard X-rays. Bear in mind, however, that these plans are designed for individuals who are in relatively good oral health. If you have major dental issues, you could still be left with significant out-of-pocket expenses.
Mid-Level Dental Plans:
Mid-level plans offer a wider selection of covered services, including:
- inhalation anesthesia,
- specialized X-rays,
- emergency treatments, and
- orthodontic services.
Premium Dental Plans:
For individuals with a history of dental issues, a premium plan may make the most financial sense. In addition to the services and procedures covered under basic and mid-level plans, premium plans often include coverage for oral surgery, crowns and other types of restorations, endodontic and periodontic procedures, and full or partial dentures.
Most dental plans work on a tiered coverage system. This means that the plan may cover 50% to 100% of your cost based on the type and complexity of the procedure or service. You can expect to pay around $350 per year for standalone dental insurance. This is lower than what you might expect to pay for a Medicare Advantage plan; however, you do not get the additional benefits for hearing, vision, or prescription services.
Are Dental Discount Plans the Same as Standalone Dental Insurance?
Although an affordable way to lower the cost of dental services, discount plans are not a form of insurance. Discount plans are sold by private companies. Plan providers negotiate discounted rates for basic services with participating dentists. Rather than a monthly or annual premium, members pay a small fee at the time of enrollment and then a monthly or annual membership fee. Another key distinction between discount plans and insurance is in how the dentist is reimbursed. With traditional insurance, the insurer reimburses the dentist. With discount plans, the member pays a flat rate directly to the dentist. Discount plans can help you save anywhere from 20% to 80% on a wide range of dental services, including:
- Routine exams
- Basic cleanings
- Standard X-rays
- Root canals
Although discount plans do not cover quite as much as traditional insurance, they do offer other advantages. For example:
- You can use your benefits while traveling as long as the dentist participates in the plan.
- You can change dentists whenever you choose.
- You don’t have to worry about copays or other out-of-pocket fees.
- You can begin using your benefits right away.
- You cannot be denied because of preexisting conditions or age.
- There are no restrictions on the number of times that you can use your benefits during the year.
- Since the discount is automatic, you don’t have to waste time filling out claim forms.
- Most discount plans allow you to receive a full refund if you cancel your membership within 30 days.
- DentRite® and other popular dental plans also include discounts for vision, hearing, and prescription services.
How Can I Manage Dental Expenses Without Dental Benefits in Northern Virginia?
An increasing number of patients are relying on payment and financing options to help manage the cost of dental care and medical care. CareCredit is one of the most popular medical financing companies and is accepted by hundreds of thousands of health care providers throughout the United States. Financing periods typically run from 24 months to as long as 60 months based on the amount being financed. Interest rates normally range from 15% to 20%, which is rather steep. You may even be able to qualify for a promotion that lets you avoid interest as long as you pay the entire balance before the promotional period ends. Like most promotional credit offers, you will be required to pay the full amount of the accrued interest if you fail to pay the full balance by the end of the promotional period. Like other forms of credit, you must meet credit and income guidelines to qualify.
Senor advocacy organizations, such as AARP, are valuable resources for information on insurance and professional service discounts for seniors.