Dental Medicare Coverage - Find Best Medicare plan option with dental coverage

Dental Medicare Coverage - Find Best Medicare Plan

dental-Medicare-coverageDental Medicare Coverage is important for seniors. Some Medicare plans include dental benefits as a no-added cost bonus. But the services and amounts covered vary. There are also stand alone senior dental plans that can be of significant value. Here are some facts about dental Medicare coverage:

  • Medicare doesn’t cover most dental care.
  • Part A (Medicare hospital insurance) will pay for certain dental services.
  • Some Medicare Advantage (Part C) plans offer extra benefits, including dental.
  • Coverage varies among Part C plans; it’s important to compare.
  • Plans may require you to use specific dentists and providers.
  • Medigap plans do not offer dental benefits
  • Stand-alone dental plans are available for seniors.
  • The average monthly cost for stand-alone dental will range from between $35 and $55.

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Find Dental Plan Options for Seniors on Medicare

Finding the best Medicare dental insurance for your needs can be confusing. There are plans included with Medicare Advantage plans. Also, stand-alone senior dental plans offered by numerous insurers. The Association does not sell insurance.

We do suggest you connect with at least one local Medicare insurance specialist. He or she will be a great resource to start your process of learning more.

Access the Association’s free directory. Simply enter your Zip Code and find agents near you.

Do Seniors Need Dental Coverage

Yes. Seniors definitely can benefit from having dental insurance. When seniors retire and join Medicare, they often lose dental benefits offered by their job. Or, they have private insurance that has gotten expensive.

Do you need dental coverage? Consider these findings from the Centers for Disease Control and Prevention:

  • One in five adults age 65 and older have untreated tooth decay.
  • About two in three adults (68%) age 65 and older have gum disease.
  • Nearly 1 in 5 adults age 65 or older have lost all of their teeth.
  • Complete tooth loss is 2x as prevalent among adults age 75 and older (compared to age 65-74).
  • Having missing teeth or wearing dentures can affect nutrition,The median age for oral cancer diagnosis is 62.
  • People with chronic diseases such as arthritis, diabetes, heart diseases, and chronic obstructive pulmonary disease (COPD) may be more likely to develop gum (periodontal) disease, but they are less likely to get dental care than adults without these chronic conditions.
  • Many prescription and over-the-counter drugs can cause dry mouth. Reduced saliva flow increases the risk of cavities.

Dental Coverage With Medicare Advantage Plans

Most Medicare Advantage dental plans included with your MA plan will cover preventive dental services. These include oral exams, dental x-rays, cleaning and even fluoride treatments. Each plan, however, will define specific limits. Most cover 100% of x-rays and cleanings. Some only cover a percentage of the cost for fillings or other services.

Plans generally have maximum out-of-pocket limits. While the average annual limit on dental coverage was $1,300 in 2021, more than half of enrollees were in a plan with a maximum benefit of $1,000 or less. Some had limits of $500.

At older ages, less common dental needs are often essential. Here’s where costs can really add up and the differences among plans can be especially important. As an example, most Medicare Advantage dental plans do not cover or pay for implants. If you are prone to needing implants, a plan that does could be a significant money saver. Our research found a plan that reimburses up to $2,000 annually.

Types of Individual (Stand-Alone) Dental Plans for Seniors

There are three key reasons to consider a stand-alone dental plan.
  1. You have Medicare Advantage (MA) coverage BUT the dental coverage is poor compared to your needs.
  2. The MA dental benefits won’t allow you to use your preferred dentist.
  3. Your Medicare coverage does not offer any dental benefits (Medigap plans don’t).
Among stand alone plans, there are generally differed types. Here is a quick look at three common types of plans for seniors.

Dental health maintenance organization (DHMO)

Choose a DHMO plan because they are typically lower cost. That’s good. Don’t choose if you don’t want a defined provider network. These plans generally only cover in-network dental coverage. Be aware that if you get treated by a dental provider outside of the designated network, you will pay the costs yourself.

Dental preferred provider organization (DPPO)

Be aware that DPPO plans typically cost more than DHMO plans. They do typically offer more flexibility. You can likely can be treated by a dentist not in the designated provider network. But there still might be at a cost. Read the details carefully.

Fee-for-service plans

Understand that fee-for-service plans can also be called dental indemnity plans. These plans allow you to see any dentist you want. Make sure the dentist will accept the insurance. Then, the plan pays a percentage of the dental services. You pay the rest of the costs.

Tips To Find The Best Medicare Dental Coverage

Here are some tips to find the best dental insurance for seniors on Medicare.

  • Think about what dental service you need?
  • Do you need dentures or implants?
  • Are your teeth in relatively good or bad shape?
  • Consider Medicare Advantage plans with dental benefits.
  • Separate dental insurance for seniors can cover more.
  • Review policy coverage carefully.
  • Read all limitations.
  • Call companies advertising their products.
  • Get a second opinion from a local insurance specialist.

Find The Best Medicare Insurance Information

Medicare insurance information 2023

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The American Association for Medicare Supplement Insurance strives to provide the best Medicare insurance information. If there is information you can’t find, please feel free to contact us.

Our Medicare insurance information center is a great resource for the latest information, statistics and data pertaining to Medicare, Medicare Advantage, Medigap and Medicare drug plans.

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