As a senior citizen, you probably already understand the importance of taking care of your teeth. You also probably know about the numerous problems that can result if you neglect them.
However, paying for proper dental care isn't cheap. Most of us rely on dental insurance to help pay for some of the expense of dental care. But for seniors, many of the available health insurance plans, including "original Medicare," lack dental coverage. This often means that seniors have to shop for new dental plans or supplementary coverage. We asked financial advisers and insurance agents to give their best tips for finding a cost-effective plan that is tailored to your needs and tips for getting the most out of your coverage as a senior.
Buy In Advance
Don't wait until you need to get a root canal to buy dental insurance. “For many dental insurance companies, there is a waiting period for coverage to take effect, so buying insurance well in advance of treatment is advised,” said Peter Young, a life insurance agent and principal of Independent Income Advisors.
"Typically, cleaning is covered right away, fillings after six months and root canals and crowns after 12 months," Young said. (To learn more, see How To Get Dental Insurance.)
Find A Dentist In Your Network
Since most dental plans are Preferred Provider Organizations (PPOs), to maximize your benefits, be sure to find a dentist in the network. If you have a favorite dentist already, find out which plan he or she participates in. “You can check the directory on your insurance company's website to see who participates in your PPO,” Young said. (To learn more, check out A Useful Guide On The Key Differences Between A PPO And An HMO.)
Make Sure That You Understand The Coverage That You're Buying
Dental policies vary widely, so you need to make sure that you read the fine print.
"Some plans pay the 'reasonable and customary' fee, while some plans pay a flat amount depending on the treatment," Young said. "Some pay only for cleanings, but offer a discount for other treatments if you go to an in-network dentist."
Look Into Plans That Cover Only The Benefits You Need
In order to save money, seniors should "choose a plan that covers only the benefits they may use," said Ray Snyder, a retired account representative for Delta Dental. Not many in the over 65 crowd will be in the market for braces, so look for plans that don't include orthodontic coverage, but do cover periodontics. Make sure to choose a plan that only offers the limited set of services that you really need.
Don't Rely On "Original Medicare"
"Original Medicare (otherwise known as Parts A and B) and MediGap plans don't cover routine dental cleanings and procedures such as fillings and crowns,” said Ross Blair, CEO of PlanPrescriber, a site that helps people compare the variety of available Medicare plans. (For more information, see What Medicare Covers: Health Coverage For When You Retire.)
"If you have a medical emergency that involves your teeth, Medicare parts A and B may cover those emergency costs, depending on what services you need and who performs them," he said. And MediGap would likely cover out-of-pocket costs for such emergencies -- but would not give you the comprehensive coverage you might be looking for.
Look Into Medicare Advantage Plans
Many Medicare Advantage (Part C) plans provide dental and vision benefits. If you already participate with one of these plans, it might be to your advantage to see if dental benefits are already covered or seek a plan that includes it.
"Check to see if the Medicare Advantage plan provides dental coverage before you buy a separate dental insurance policy," Blair said.
"Medicare Advantage plans must, at a minimum, provide the same basic benefits as Medicare parts A & B, as well as have a clearly defined provider network and a $6,700 cap on your out-of-pocket expenses," he said. "But, most do also include a prescription drug benefit and many include additional benefits like vision and dental coverage."
Some people claim that Medicare plans cost as little as half the price of regular senior dental plans, so they are worth exploring.
Get To Know Your Real Costs
Most dental insurance plans involve co-pays, deductibles and coinsurance which may translate into additional out-of-pocket costs to you.
"Be sure to know how much you'll spend for regular check-ups or emergency dental work," Blair said. And keep in mind that procedures such as crowns and root canals may have higher deductibles and co-pays associated with them.
Looking For Veneers Or Whitening Treatments?
Teeth whitening, veneers or dental implants probably will not be covered through a senior dental insurance plan.
"There may be plans out there that provide those benefits, but they're not the norm," Blair said.
If you’re in the market for senior dental insurance, your first step is to look into any existing coverage you already have through a Medicare Advantage plan. Then research plans by reading literature or comparing plans online. Don’t forget to ask your friends and neighbors about which plans they like or which ones they have steered away from.
Before long, those pearly whites will be getting the attention they need.