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A Definitive Guide to Dental Insurance, Dental Discount Plans, and Medicare Advantage in Yonkers
Our need for dental services does not end once we turn 65 or retire, yet that is when we are likely to have the fewest options for affordable dental benefits. In fact, nearly two-thirds of seniors are forced to pay out of pocket for basic dental services. Despite this lack of affordable benefit options, dental spending among seniors totaled more than $28 billion in 2016 alone. According to the American Dental Association Health Policy Institute, the number of seniors visiting a dentist increased by 6 million between 2006 and 2016. This represents the highest growth rate in dental spending of any portion of the population. The following looks at a few ways in which seniors can get the dental services they need without emptying their wallets.
Going without dental benefits in Yonkers can be a costly proposition. According to the Kaiser Family Foundation, 19% of Medicare recipients who reported visiting the dentist in the past year ended up spending at least $1,000 out of their own pocket. For seniors who may be on a fixed income, this can mean doing without food, medicine, and other necessities. The following is an overview of the typical cost for common dental services without dental insurance:
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.
What Should I Consider When Choosing Dental Benefits in Yonkers?
Employer-sponsored dental plans are the most common way Americans get their dental benefits in Yonkers. This means that coverage ends with retirement. To make the situation even more difficult, Medicare, which is the primary source of health benefits for seniors, does not include benefits for routine dental services. Under limited circumstances, a basic dental exam may be covered under Medicare Part A hospital benefits, like when it is required as part of another covered procedure. Because of limited options, 65% of seniors do not have any type of dental coverage. With more than 10,000 baby boomers turning 65 each year, that percentage is only going to grow in the coming years. Approximately 25% of seniors rely on Medicare Advantage plans for their dental coverage. Another 10% opt to purchase a comprehensive plan through a private insurer. When choosing dental benefits, the prime considerations are cost and whether the plan covers the type of services that you are likely to need.
Is Dental Care Covered If I Have Medicare Advantage?
Most Medicare Advantage supplement plans offer basic dental benefits for routine exams, cleanings, and standard X-rays. The plans are purchased from private insurers and add to the benefits offered by traditional Medicare. Aetna, UHC, and Humana are among the leading providers of Medicare supplement plans. For an average premium of around $420, you can receive the following:
- access to a network of approved providers;
- limits on out-of-pocket expenses; and
- vision, hearing, and prescription drug benefits.
Unlike basic Medicare where the government reimburses providers for their services, the benefits offered under supplement plans are paid for directly by the insurer. If you enroll in a Medicare supplement plan, you will normally receive a second ID card from the plan provider in addition to the red, white, and blue ID card that comes with basic Medicare.
What Are the Benefits and Drawbacks of Standalone Dental Insurance?
With an average cost of $350 per year, standalone dental insurance is relatively economical. Unlike Medicare Advantage plans, however, standalone insurance normally does not include benefits for vision, hearing, or prescription services. Dental plans typically cover anywhere from 50% to 100% of the cost based on the type of service. You can also choose from plans that cover different types of services and come with different price points.
Basic Dental Plans:
If you are simply interested in coverage for preventative and prophylactic services, then a basic dental plan may be right for you. These plans cover routine exams and cleanings as well as standard X-rays.
Mid-Level Dental Plans:
For a few more dollars a month, you can choose a mid-level dental plan that offers expanded coverage for orthodontics, specialized X-rays, emergency services, fillings, dentures, and inhalation anesthesia.
Premium Dental Plans:
If you anticipate needing extensive dental work, then a premium dental plan may be the best option for you. These plans offer at least partial coverage for advanced dental services, including:
- inlays and onlays,
- complete and partial dentures,
- oral surgery,
- periodontal procedures, and
- endodontic procedures.
Is It Possible to Get Discounts for Dental Services?
One way to lower the cost of dental services is to enroll in a dental discount plan. Although sold by private companies, discount plans are not a form of insurance. The plan provider negotiates discounted rates for services with participating providers. As a plan member, you pay an enrollment and membership fee instead of an annual premium. This fee is typically far less than any insurance premium. You then pay the provider directly for the service at the discounted flat rate. Depending on the service, discounts can range anywhere from 20% to 80%. Common services covered by dental plans include:
- Crowns and other types of restorations
- Root canals
- Routine exams
Although a standalone dental plan may still offer the most savings for individuals with significant dental needs, discount plans do offer several advantages over traditional insurance. For example:
- The discount is automatic, so you don’t have to worry about paperwork.
- You have the freedom to see any dentist that accepts the plan and can change providers at any time.
- You don’t have to worry about copays, deductibles, or hidden fees.
- You can use your benefits as many times as you want throughout the year.
- Unlike traditional insurance, you cannot be denied because of age or preexisting conditions.
- There are no exclusion periods before you can use your full benefits.
- You can include family members on your plan.
- If you cancel your plan within 30 days, you can receive a full refund minus the nonrefundable processing fee.
In addition to dental discounts, many discount plans, such as DentRite®, also provide discounts for other health and wellness services, including vision, hearing, and prescription drugs. Discount plans work well for individuals primarily concerned about routine maintenance and the occasional procedure. If you have multiple dental issues, however, a private insurance plan may still be your best option.
Can I Finance the Cost of My Dental Expenses?
If you have a decent credit history, you may be able to finance the cost of your dental care. For example, CareCredit is a popular financing option that is accepted by more than 200,000 medical and dental providers and health and wellness facilities nationwide. Depending on the amount being financed, you may be able to pay for the cost of your treatment in installments over two to five years. Some medical financing companies even offer promotional financing with no interest as long as you pay the entire balance in full by the end of the promotional period. If you don’t pay the full balance, you will be responsible for paying the accrued interest. Of course, not everyone is approved. The interest, which averages between 15% and 20%, also adds to the final cost of your treatment.
Senior organizations, such as AARP, are also valuable resources for information on discounts and insurance options geared toward seniors.