How to Get the Best Dental Coverage for Seniors on Medicare?
Dental care is an important part of overall health, but it can be costly. Seniors on Medicare often have questions about what dental coverage is available to them and how to get the best coverage.
This blog post will answer those questions and provide information on the different types of dental coverage available to seniors on Medicare, how to choose the best coverage, and the best Medicare plans for dental coverage.
Table of Contents
Dental Coverage for Seniors on Medicare
What is Medicare?
Medicare is a health insurance program for people 65 years of age and older, as well as for some younger people with disabilities. It is administered by the federal government’s Centers for Medicare & Medicaid Services (CMS).
Medicare has four parts: Part A, Part B, Part C, and Part D.
Part A covers inpatient hospital care, skilled nursing facility care, hospice care, and home health care.
Part B covers outpatient medical care, preventive services, and some dental and vision services.
Part C is also known as Medicare Advantage. It covers the same benefits as Parts A and B, but it is offered by private insurance companies rather than the government.
Part D covers prescription drugs.
What Does Medicare Cover?
Original Medicare (Parts A and B) does not cover routine dental care or dentures. However, it does cover some dental services that are considered medically necessary, such as tooth extractions that are caused by an injury or illness.
There are three main ways for seniors to get dental coverage on Medicare: through a stand-alone dental plan, a Medicare Advantage plan with dental coverage, or a Medicare Supplement plan with dental coverage.
How to Get the Best Dental Coverage on Medicare
The best way to get dental coverage on Medicare will depend on your individual needs and budget. If you only need basic dental coverage, a stand-alone dental plan may be the best option for you. These plans typically have lower monthly premiums than plans that include other types of coverage like vision or prescription drugs.
If you need more comprehensive coverage, you may want to consider a Medicare Advantage plan that includes dental benefits. These plans typically have higher monthly premiums than stand-alone dental plans but may offer additional features like routine vision or prescription drug coverage.
You can also get dental coverage through a Medicare Supplement plan if you already have Original Medicare (Parts A and B). These plans help pay for out-of-pocket costs not covered by Original Medicare such as deductibles, coinsurance, and copayments. Some supplement plans also offer additional benefits like routine vision or prescription drug coverage.
The Different Types of Dental Coverage on Medicare
Medicare Advantage Plans
Medicare Advantage plans are an alternative to Original Medicare. These plans are offered by private insurance companies and they must cover everything that Original Medicare covers. Many Medicare Advantage plans also offer additional benefits, like routine dental and vision coverage. Some plans may also offer prescription drug coverage.
To enroll in a Medicare Advantage plan, you must first be enrolled in both Parts A and B of Original Medicare. You will then need to choose a plan that is available in your area. There are many different types of Medicare Advantage plans, so it’s important to compare the costs and benefits of each one before enrolling.
Supplement plans are also known as Medigap plans and they help to cover the gaps in Original Medicare coverage. These plans are offered by private insurance companies and they can help to pay for things like deductibles, coinsurance, and copayments. There are 10 different types of supplement plans available, so it’s important to compare the costs and benefits of each one before enrolling.
Discount Dental Plans
Discount dental plans are not insurance policies, but they can help you save money on dental care services. These plans work with a network of dentists who have agreed to provide discounted rates to plan members. To enroll in a discount dental plan, you simply need to choose a plan that is available in your area and pay the annual membership fee. Then, you can start using your discount at any participating dentist right away!
How to Choose the Best Dental Coverage on Medicare
Consider Your Dental Needs
When you’re trying to decide on the best dental coverage for seniors on Medicare, the first thing you need to do is take a good look at your own dental needs. If you have a lot of dental work that needs to be done, then you’re going to want to make sure that the plan you choose covers as much of it as possible. On the other hand, if you only need basic dental care, then you might be able to get by with a less comprehensive plan.
It’s also important to think about how often you’ll need to see the dentist. If you only need to go once or twice a year for cleanings and checkups, then you might not need as much coverage as someone who needs to go more often.
Compare Plans and Costs
Once you know what your dental needs are, it’s time to start comparing plans and costs. There are a few different ways to get dental coverage through Medicare: Medicare Advantage Plans, Supplement Plans, and Discount Dental Plans.
Medicare Advantage Plans are offered by private insurance companies and cover all of your Medicare Part A and Part B benefits, plus extra benefits like dental coverage. Supplement Plans only cover some of your Medicare Part A and Part B benefits, so they won’t cover extra benefits like dental coverage. Discount Dental Plans are offered by private companies and can help you save money on dental services from participating dentists.
To compare plans and costs, first check out the websites of the different companies that offer them. Then, call each company and ask about their plans and prices. Be sure to ask about any discounts or special offers they have for seniors on Medicare. Once you’ve gathered all this information, you’ll be able to compare apples-to-apples and choose the best plan for your needs and budget.
Read the Fine Print
Before enrolling in any type of dental coverage, it’s important that you read the fine print carefully. This way, you’ll know exactly what is covered and what isn’t covered by your plan. For example, some plans may have waiting periods before certain services are covered or may not cover pre-existing conditions at all. Other plans may have lifetime maximums or limits on how often you can visit the dentist in a year. Be sure to understand all these details before enrolling in a plan so there aren’t any surprises down the road when you need to use your coverage.
There’s a lot to consider when choosing the best dental coverage for seniors on Medicare, but it doesn’t have to be overwhelming. Just take some time to think about your own needs, compare plans and costs, and read the fine print carefully. With a little research, you can find the perfect plan for you and get the dental care you need without breaking the bank.
Best Medicare plans for dental coverage
Should Seniors Buy Dental Insurance?
There’s no one definitive answer to this question. Ultimately, it depends on your individual dental needs and budget. However, seniors on Medicare can often find good value in dental insurance plans, especially if they take advantage of available discounts.
For example, many insurers offer discounts for seniors who enroll in automatic payment plans. This can help make dental coverage more affordable for those on a fixed income. Additionally, some insurers offer free or discounted preventive care services, such as oral exams and cleanings. These services can help you avoid more costly dental problems down the road.
Of course, it’s important to compare different dental insurance plans before enrolling in one. Be sure to consider factors like coverage limits, deductibles, and copayments/coinsurance levels. You can use some tools online to compare Medicare dental plans and find the best option for you.
What Do Plans Designed for Seniors Cost?
Dental insurance premiums for seniors vary depending on the insurer and the type of plan selected. However, seniors on Medicare can often find competitively-priced dental insurance plans. For example, according to eHealth’s 2020 sample data of people aged 65+, the average monthly premium for a standalone dental plan was $35.60.* This is significantly lower than the average monthly premium for a Medicare Advantage plan ($74.48),* which typically includes dental coverage along with other benefits like prescription drug coverage and routine vision services.
What Does Dental Insurance for Seniors Over 65 Cover?
Dental insurance plans for seniors typically cover preventive, basic, and major dental services. However, coverage levels and exact benefits vary depending on the insurer and the type of plan selected.
Preventive dental services are those that help maintain your oral health and prevent problems from occurring. These services are often covered at 100% by dental insurance plans. They may include routine oral exams, teeth cleanings, and X-rays.
Basic dental services are those needed to treat common problems like tooth decay or gum disease. These services are usually covered at a lower level than preventive services (e.g., 50-80%). They may include fillings, extractions, and periodontal cleanings.
Major dental services are those needed to treat more serious problems like tooth damage or loss. These services typically have the lowest level of coverage (e.g., 50%). They may include crowns, bridges, dentures, and implants.
Some dental insurance plans also offer additional benefits like orthodontic coverage or discounts on non-covered services. Be sure to compare different plans before enrolling in one to make sure you’re getting the coverage you need at a price you can afford.
What About Dental Discount Plans?
Dental discount plans are not insurance plans. Instead, they are membership programs that offer discounts on dental services from participating providers.
Dental discount plans can be a good option for seniors who don’t have dental insurance or who want to supplement their existing coverage. However, it’s important to compare the costs and benefits of different plans before enrolling in one. Additionally, keep in mind that dental discount plans typically do not cover preventive, basic, or major dental services.
Dental for seniors on medicare FAQ
Does Medicare cover dental care?
No, Medicare does not cover routine dental care. This includes cleanings, fillings, and extractions. However, it may cover certain types of dental procedures that are considered medically necessary, such as those related to an injury or infection.
What dental care does Medicare Part A cover?
Medicare Part A covers inpatient hospital stays for medically necessary procedures, including some dental procedures. However, it does not cover routine dental care or outpatient visits to the dentist.
How does Medicare Advantage dental coverage work?
Medicare Advantage plans are an alternative to Original Medicare (Part A and Part B). These plans are offered by private insurance companies and must provide at least the same level of coverage as Original Medicare. Some Medicare Advantage plans offer additional benefits, such as routine dental coverage.
When should you get a standalone dental plan?
If you want routine dental coverage, you will need to purchase a standalone dental plan or enroll in a Medicare Advantage plan that offers this benefit. Standalone dental plans are offered by private insurance companies and typically have lower monthly premiums than comprehensive health insurance plans that include dental coverage.
However, you will pay more out-of-pocket for services since these plans have high deductibles and copayments/coinsurance rates.
You may also need to use in-network providers and could be subject to annual maximums and waiting periods for certain services.
How could Medicare dental coverage change in 2022?
Starting in 2022, Medicare Advantage plans will be required to offer basic dental coverage. This means that all new and existing Medicare Advantage plans will need to cover preventive services, such as cleanings and screenings, at no cost to enrollees.
However, other types of dental services, such as fillings and extractions, will still require a copayment or coinsurance.
This change could make it easier for seniors to get routine dental care covered by their insurance.
In this blog post, we went over some of the different types of dental coverage available on Medicare and how to choose the best plan for your needs.
Original Medicare (Parts A and B) does not cover most dental services, but there are a few ways you can get dental coverage through Medicare Advantage plans, supplement plans, or discount dental plans. When choosing a plan, it’s important to consider your dental needs and compare the cost of different plans before making a decision.
The best Medicare plan for dental coverage will vary depending on your individual needs, but should provide good coverage at a reasonable price. If you’re not sure which plan is right for you, be sure to read the fine print and talk to a licensed agent who can help you compare your options.