Dental Insurance for Seniors

One of the most common misconceptions that many people have is that once they retire they will have medical plus dental insurance for seniors. In actuality, there is no dental coverage on Medicare and at best there is really limited medical coverage! There are, however, a few exceptions to the rule.

Medicare Exceptions for Dental Coverage
The only time Medicare would ‘kick in’ would be if complications arose from an infected tooth or oral surgery that required the individual to be hospitalized. The other reason for which Medicare ‘might’ cover dental services is perhaps if a dental exam would be required prior to some form of medically necessary surgery such as on a major organ or perhaps after an injury to the face or jaw. All other times the person would be required to foot all expenses out of pocket or to carry private dental insurance for seniors.

Medigap Does Not Cover Dentistry
Within the past couple of decades Medicare has become so confusing that even the people in Washington D.C. can barely interpret the law any more. It used to be a straightforward Part A and Part B but now Medicare goes all the way up through the letter L and in effect, none of them are ‘free,’ and certainly none of those parts cover dentistry. While Medigap is a supplemental insurance plan that enables seniors to purchase gaps in coverage left behind by Medicare, only those services that have been approved by legislators are covered. Unfortunately dental care is not one of them and again, if you want dental insurance you would need to find dental insurance for seniors.

Medicare Dental Advantage Plans
A Medicare Advantage Plan with dental benefits is also run by private insurance companies, much like Medigap coverage except that there is a broader range of services which can be covered, depending on the plan you purchase. Some Medicare Advantage Plans include dental services while others do not. Before purchasing this type of coverage it is suggested that you compare various providers and the plans they have to offer. Not all of these plans have dental benefits and some of the benefits require you to choose particular providers, while some require a co pay at the time of treatment. Unlike Medigap insurance, doctors are not required to accept Advantage Plans if they have opted out of accepting the plans at their practice.

AARP Delta Dental Plans
AARP has two plans available for seniors 50 years of age or older which begin at $41 to $56 per month for a single person, with higher premiums when spouses are covered. There are annual caps on the benefits and some mandatory waiting periods prior to certain coverages. For those services which are covered, there is generally a co-pay amounting to as much as 50% of the cost. Also, there may be a mandatory enrollment term, and you would need to choose from two networks of dentists in order to receive maximum benefits. If you choose a dentist who isn’t part of the network you are free to do so but your out of pocket expense would be much higher.

Many seniors just don’t have money to pay for dental benefits after paying part of their Social Security check for Medicare Part B, Part D (prescription drug coverage), and Medigap or Supplemental Insurance. Another $50 a month is just unreasonable in many cases. Another option would be one of many private dental plans that cost as little as $6.95 per month, and although they are not dental insurance for seniors in the traditional sense, they cover dental services by as much as 60%. While you would be required to pay your share out of pocket at the time of services and there is no reimbursement like you would get with traditional dental insurance, these plans allow a greater number of seniors to get the dental work they need at considerably discounted fees.

Comments are closed.