Medicare Advantage dental benefits in West Bend (Seniors 65+)

Overview of Dental Insurance Options for Seniors

Once a senior turns 65 years old, he or she is automatically enrolled in Medicare. In addition, adults who are permanently disabled and those with a chronic kidney disease are also eligible for Medicare. While there are numerous advantages to being a Medicare beneficiary, most traditional Medicare plans don't include coverage for dental care. Even basic services like cleanings, exams, fillings, dentures, or extractions aren't usually covered. However, with options such as a Medicare Advantage plan, discount plans, private insurance, or in-office financing, it's possible to manage the cost of dental services. Contact us today for more information about dental benefits in West Bend. 

Since total costs can vary depending on your location and the extent of your dental issues, the amount you pay out-of-pocket for dental benefits can vary. Consider the following list for a general overview of the costs associated with common dental procedures:

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 Are Medicare Advantage Plans?

A Medicare Advantage plan is an optional plan for seniors that can be purchased in addition to traditional Medicare benefits. It’s a supplemental plan that's offered by private insurance companies; for example, UHC, Aetna, and Humana are some of the most popular companies. These private companies usually provide additional benefits, such as hearing, vision, and dental benefits, in addition to coverage for prescription medications.

As a beneficiary of a Medicare Advantage plan, you'll be given access to numerous network providers. Some plans may also allow you to choose your own healthcare provider. The majority of these plans have additional benefits, including cost-sharing and price protection measures, like limits on out-of-pocket spending and reduced costs on deductibles and premiums. Benefits associated with Medicare supplement plans are paid directly by the insurance company. This differs from basic Medicare, which is reimbursed by the federal government.

Once you're enrolled in a Medicare supplement plan, you'll get another ID card that's used in addition to your usual blue, white, and red Medicare card. Due to their low monthly premiums, supplemental plans to Medicare are cost-effective for most seniors. However, it should be taken into consideration that these plans usually cover basic services, such as standard exams, cleanings, and x-rays. Research conducted by the Centers for Medicare and Medicaid Services suggests that seniors can expect to pay an average of $28.00 a month for Medicare Advantage plans in 2019. 

Can I Benefit from Standalone Dental Insurance?

If you'd like to receive comprehensive dental benefits that aren't offered by a Medicare supplement plan, standalone dental insurance may be a viable option for you. With a variety of coverage levels to choose from, seniors can pick a plan that suits their budget and oral care needs.

Basic Plans:

If you're in otherwise good oral health, a basic plan that covers preventative and diagnostic dental services, including professional cleanings, exams, and x-rays, may work for you. Since it's the plan that offers the least amount of coverage, the basic plan is typically the cheapest.

Mid-level Plans:

A mid-level plan offers a more balanced selection of services. It offers coverage for a wide range of common dental problems, including orthodontic treatment, emergency treatment, fillings, inhalation anesthesia, dentures, and specialized x-rays. These services are provided in addition to the preventative dental services offered by the basic-level plan.  

Premium Plans:

The premium standalone plans provide the most coverage of the three plan types, but it is the most expensive. However, a premium plan can reduce your out-of-pocket costs if you ever require extensive dental work, such as:

• Crowns
• Oral surgery
• Dental restoration services, including inlays and onlays
• Complete or partial dentures
• Treatment for gum disease, such as endodontic and periodontal procedures

Providers of standalone plans offer coverage based on the level of services you receive. As part of their tiered coverage called "100-80-50," preventative procedures are typically covered at 100%, fillings and other basic services are 80% covered, and crowns and other advanced procedures are usually 50% covered.

The average cost of your private dental plan will vary and is determined based on the coverage you're receiving. While members of a private dental plan usually get more dental coverage when compared to a Medicare supplement plan, beneficiaries usually don't get the extra benefits that are associated with a supplement plan, such as prescription medications, hearing, and vision. 

What Are the Alternatives to Insurance for Dental Service?

Dental discount plans can be a viable alternative to traditional insurance, especially if you're in otherwise good oral health and only require basic dental services, such as:

• Cleanings
• Exams
• Fillings
• X-rays
• Crowns
• Root canals
• Dentures
• Extractions

Discount plans, such as Smile Alliance Club, are offered by private companies and they allow individuals to pay a discounted price for common dental services. Unlike traditional insurance, members don't pay a monthly or annual premium. Rather, they pay an enrollment fee and a small monthly membership fee. Patients will still pay their dentist directly for services provided but at a discounted rate.

Most discount plans are quite affordable and offer specific advantages over traditional insurance:

• There isn't a waiting period, so you can use your benefits right away.
• You can switch dentists at any time.
• There aren't any copays, deductibles, or paperwork to fill out.
• There typically aren't any restrictions due to age or pre-existing conditions.
• There aren't any limits on how often you can use your benefits.

One potential disadvantage to discount plans is they usually don't cover as many services as traditional insurance. This is an important point to consider if you require advanced dental work or several complex procedures. In these situations, traditional insurance for dental services will likely save you more money than a discount plan.

How Can I Manage My Costly Dental Expenses?

If you don't have insurance or dental benefits in West Bend, there other ways to help you manage out-of-pocket dental costs. Many dental practices offer in-house financing and payment plans. During your next visit to our office, we encourage you to ask about flexible payment plans.

Seniors can also apply for CareCredit, a financing program that's accepted by hundreds of thousands of healthcare providers across the nation. CareCredit works in a similar manner to a credit card and allows users to make easy monthly payments. Many medical credit companies offer short-term financing for up to two years, and many will offer interest-free payments if your balance is paid in full before the end of your promotional period. If you have a larger expense, there are also long-term financing options of up to five years.

Potential drawbacks to financing from medical credit companies include a check of your credit history, which will disqualify some applicants, and high interest rates that can cause you to pay more for the cost of care. Interest rates can range from 15% to 20% for most medical credit companies.

Senior organizations, such as the American Association of Retired Persons (AARP) are good resources to learn more about insurance options and financing programs. You can also get in touch with us for more information.