Insurance & Finance

Dental Insurance For Seniors – Medicare Dental Coverage

Today we’re going to see about Medicare and Dental coverage. In most instances, Medicare will not pay for dental care except in extreme circumstances. This type of event would be medical related like if you fell and broke your jaw and then you needed dental repair work. But most of you want to know about coverage for cleanings, fillings, root canals, and extractions. Medicare is not going to cover these types of expenses.

There are a couple of ways to get Dental coverage when you have Medicare. We’re able to help many of our clients get some dental benefits through a Medicare Advantage plan such as a PPO or HMO plan. There are limitations with these dental benefits such as Networks and annual limits, but most of the time there are no extra monthly costs for basic services with these plans. If a Medicare Advantage plan is not an option for you, or if you have a Medigap Plan such as Plan G or N, then you can enroll in a Dental plan that you pay for separately.

Our #1 recommended plan and most popular plan with our clients is a combined benefits plan that covers Dental, Vision, and Hearing. This means you can get up to a specific annual benefit amount for either one or all combined. So if you used half your annual benefit toward dental, you could use the remainder toward vision, hearing, or more dental.

Here are some of the highlights of this plan: You can choose your Dentist, either In the Network or Out of the Network. Using a Network Dentist is completely optional but you would get reduced charges. The annual benefit maximums range from $1000 to $3000 and there is a one-time annual deductible of $100. The great thing about this plan is that it pays a higher percentage the longer you keep it. So in year 1, the benefit paid by the company is 60%, second year 70%, in the third year, and thereafter 80%.

For the Dental, there are no waiting periods for Cleanings, exams, ex-rays, and extractions. There is a 12-month waiting period for Major services, but after the first 12 months, you’re at 70% coverage in the 13th month, your portion of the bill would only be 30%.

For Vision, there is no waiting period for eye exams and only a 6-month wait for eyeglasses or contacts. The Hearing benefit has no waiting period for exams or hearing aid repairs and supplies and a 12-month waiting period for hearing aids. Again, after the first 12 months, you’re at 70% coverage.

One other option for seniors is to get a discount Dental Plan. There is typically a one-time annual cost for the plan, a Network of Dentists, and discounts from 10-60% with no waiting periods. If paying extra for a Dental plan gets you down then this is a great option to get the dental work you need taken care of at a discounted price.

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