When is the last time you thought about your teeth? If you're a senior citizen, it's more important than ever to properly care for your teeth, if you want to keep them. Gum disease is the leading cause of tooth loss; therefore, you must practice good oral hygiene and secure a dental health plan that suits your particular needs. Don't assume your dental needs will be covered by Medicare and Medicaid? You might be surprised by the answer.
Surprising Facts about Dental Care for Seniors on Medicare and Medicaid
Unfortunately, Medicare generally does not include routine and preventive dental coverage. However, as of 1980 when an amendment to Medicare was enacted, it now includes Medicare coverage, but only for people who require inpatient hospital services. Therefore, if you want overall general dental care, you will need to purchase either a Medicare Advantage plan with dental benefits, a Medigap plan with dental benefits, an individual dental plan or a dental discount plan.
Dental Health Insurance Options for Seniors
The best way to find a dental insurance plan that's right for you should begin by narrowing down your particular needs. Then proceed with finding a plan that meets those needs. There are several different ways dental plans are offered.
Indemnity Dental Insurance Plans
An indemnity dental plan involves dentists who don't participate in a dental network. Generally, an insurance company will pay the dentist a percentage of the services you received based on the policy coverage you purchased. Often times these types of plans require co-payments, waiting periods, deductibles, graduated percentage scales based on the procedure and annual limitations, along with other policy specific requirements.
Dental Health Managed Organization (DHMO)
A DHMO plan is when a dentist signs a contract with an insurance company and accepts an insurance fee schedule to offer the insurance company's customers a reduced cost for in-network dental services. Generally, there are little to no waiting periods, no annual maximum benefit limits, shorter periods before major dental work is covered and some even offer semi-annual preventive treatments, but might have varying limitations for fillings, crowns, implants and dentures.
Participating Provider Network (PPO)
A PPO is very similar to a DHMO whereas you use an in-network provider; however, with a PPO, you are also allowed to use an out-of-network provider. The caveat is any fee differences will become your financial responsibility. Additionally, there might be an annual maximum benefit limit and any expenses incurred after reaching the maximum benefit will be your responsibility, depending on your particular plan.
Finding A Dental Insurance Provider
There are several different ways you can approach your research for finding a dental care provider. You could perform an internet search using a dental plan comparison company such as eHealthinsurance.com. This source allows you to enter your zip code and answer a few questions. The system will then compile a list of insurance companies that, based on your answers, can service your needs. You can then sort the results by top rated providers, budget, etc. Another method is to check the healthcare.gov website, which also offers affordable dental care options. Dental coverage is not required by law; however, it is available for purchase.
AARP dental coverage is another popular option with seniors as they provide guaranteed acceptance for all members and their premiums are guaranteed for two years. AARP has several plan choices with no waiting periods on select services, as well as many other attractive plan options.
The Bottom Line
Purchasing a routine dental care plan is particularly important for seniors due to age related diseases, as well as unforeseen events that could become a huge financial burden otherwise. Spend some time researching your dental options. Then take as much time as you need to make an educated decision about which plan is right for you. Knowledge is the key to helping you save hundreds, if not thousands of dollars in your overall dental expenses.