(386) 246-7619

Oceans Dental Group
3 Pine Cone Drive, Suite 108, Palm Coast, FL 32137

Medicare Advantage Dental Benefits in Palm Coast (Seniors 65+)

No matter your age, it’s important to maintain good dental health. Unfortunately, many seniors over the age of 65 do not see a dentist due to a lack of insurance. Most of the time, medical insurance is provided through employers, and seniors often find themselves without dental benefits in Palm Coast one they exit the workforce. Seniors must then seek other options for medical coverage, including Medicare Advantage plans and dental discount memberships. Today, nearly two-thirds of seniors do not have dental coverage, and this number will rise as 10,000 Americans reach the age of 65 daily.

Even though many seniors lack insurance, dental spending is rising – just last year, seniors spent more than $28 billion on dental care. They are continuing to outspend other demographics on dentistry, and 6 million more seniors saw a dentist in 2016 than they did in 2006. This number is expected to increase over time, according to the American Dental Association Health Policy Institute.

While spending on dentistry is increasing among seniors, almost half of Medicare recipients haven’t visited a dentist over the past year, Kaiser Family Foundation research revealed. Plus, 19% of these seniors spent $1,000 out of pocket when they did see the dentist. The following list offers insight into current dental costs:

Checkups and Cleanings:

  • Basic exam–$50 to $100
  • Dental X-ray–$20 to $250
  • Standard cleaning–$70 to $200

Fillings:

  • Silver amalgam–$50 to $300
  • Composite–$90 to $450

Extractions:

  • 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

Crowns:

The cost of a crown can range from $500 to $3,000 based on the type of material used.

Root Canals:

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 Options Do Seniors Have for Dental Insurance?

If you’re over 65 and looking for dental benefits in Palm Coast, it’s important to understand your options. Anyone over 65 or permanently disabled is enrolled in Medicare, which covers medical needs. Medicare recipients have a red, white, and blue card that is presented when receiving services. However, Medicare does not cover routine dental exams and cleanings, leaving many seniors at risk of developing dental health problems. In fact, dental exams are usually only covered under Part A if they are necessary to clear patients for surgery.

These limitations often leave seniors searching for other ways to make dental costs more affordable. Many seniors may look to private companies for dental insurance coverage while a quarter of them will purchase a Medicare Advantage plan.

How Do Medicare Advantage Plans Work?

With an Advantage plan, your existing Medicare benefits are supplemented to provide more savings and flexibility with medical costs. Seniors choosing an Advantage plan will have access to an expanded network of providers as well as price protection through lower deductibles and out-of-pocket spending limits. Advantage plans are different from traditional Medicare plans because they are reimbursed by a private company, not the government. The plans provide expanded coverage for medical care, but the benefits often extend to dental care, eye care, and medications. Some popular Medicare Advantage Providers include Aetna, Humana and UHC.

Advantage plan participants receive a separate ID card to be presented during dental visits. Premiums are typically low – most Advantage plan participants spent approximately $420 on premiums in 2018, according to MedicareAdvantage.com. However, benefits can be limited, covering only preventive care like X-rays, cleanings and exams.

Why Should I Consider Standalone Dental Insurance?

Standalone dental insurance plans are ideal for those requiring comprehensive dental coverage, such as patients with ongoing dental health issues. These plans are offered through private insurance companies and often have several levels of coverage. Your premium costs, what’s covered, and the percentage of total costs covered will depend on what level of plan you choose. Listed below are three common types of standalone plans:

Basic: This type of plan usually covers preventive, routine dental services, including X-rays, oral cancer screenings, and tooth cleanings.

Mid-level: Increased coverage is available with a mid-level plan, including orthodontics, emergency dentistry, panoramic X-rays, and sedation using nitrous oxide.

Premium: This plan offers the maximum coverage available, including benefits for advance dental procedures. If you require extensive dental work, a premium plan may meet your needs. 

These plans often cover:

  • Crowns and fillings
  • Onlays and inlays
  • Treatment for endodontic issues
  • Dental surgery
  • Dentures
  • Periodontal treatment

With a private dental plan, you’ll often see tiered coverage of “100-80-50.” This typically means that routine exams are 100% covered, basic procedures are 80% covered, and more complicated procedures are 50% covered. Bankrate analysis revealed that private dental plans cost $350 per year on average. While this cost is lower than a Medicare Advantage premium, private plans often don’t have the expanded eye care, hearing and medication benefits that an Advantage plan provides.

Should I Enroll in a Dental Discount Plan?

Dental discount plans are sold by private companies, but it’s important to note that they are not insurance. Instead, discount plans offer members savings on general, cosmetic, and restorative services by negotiating with the dental provider. Members pay an enrollment fee and an affordable monthly payment to participate in the discount program. They also pay the dental office directly instead of going through a claims process.

With low monthly fees, a dental discount plan usually is an affordable option for patients of all budgets. They also have several key benefits, including:

  • No waiting period before receiving treatment
  • No copays, coinsurance requirements, or deductibles
  • There are no limits on how often you can see the dentist
  • You can choose a new dental provider at any time
  • Discounts can be used without a claim or paperwork
  • Plans have no exclusions for age or preexisting conditions

Discount plans often don’t provide as much coverage as traditional insurance plans, but they do offer savings on many routine treatments. Some of these services include:

  • Dental checkups and cleanings
  • X-ray evaluations
  • Tooth extractions
  • Fillings and crowns
  • Root canal therapy
  • Dentures and other restorations

Many well-known discount plans, including those from DentRite, provide reduced rates on medication, vision exams, and hearing aids. Those who are in generally good dental health and will only need routine treatment may be good candidates for a discount plan.

How Can Seniors Manage Out-of-Pocket Dental Expenses?

Many seniors are on a fixed income, making managing dental costs important. Oftentimes, flexible financing can make significant dental costs more affordable. One option is financing through CareCredit, which is accepted at more than 200,000 locations across the U.S. Credit companies like CareCredit usually provide both short- and long-term financing, and with short-term financing, there is sometimes no interest if the balance is paid off during the promotional period. However, we encourage all patients to consider the potential drawbacks of taking out credit to cover dental costs. Some of the considerations include:

  • The application and approval process – because credit scores will be factored in, not every patient will be accepted
  • Potentially high interest rates between 15-20% or more for long-term financing, adding to the overall dental costs

It’s recommended that all seniors explore the various options when looking for dental benefits in Palm Coast. Two excellent resources for benefit information are the AARP and local seniors’ organizations. We’re also here to answer any questions you have – call us now to learn what discount plans or special savings are available.

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Oceans Dental Group

3 Pine Cone Drive, Suite 108, Palm Coast, FL 32137

(386) 246-7619

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