Medicare advantage dental benefits in East Detroit (Seniors 65+)

What Choices Do Seniors Have for Dental Benefits in East Detroit

When you turn 65 and start receiving Social Security, you’re automatically enrolled in Original Medicare, which is also for people who are permanently disabled or have certain diseases, such as ALS. Medicare is the U.S. government’s medical insurance program administered by the Centers for Medicare and Medicaid Services (CMS). Seniors can visit any hospital or doctor which accepts Medicare when they have Part A and Part B coverage which are Medicare’s hospital stay and medical insurance. For prescription drug coverage, seniors would have to buy Part D. One expense traditional Medicare does not cover is dental care unless it is medically necessary. This means a physician would have to verify an oral health issue could complicate medical treatment, thus requiring treatment to be covered. Medically necessary dental work is rare, therefore, senior citizens cannot count on Medicare to provide dental benefits. Seniors can get dental benefits from standalone dental insurance, discount plans or Medicare Advantage plans.

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 Is a Medicare Advantage Plan?

Medicare Advantage plans, also called Medicare Part C plans, are offered by Medicare-approved insurance companies. Medicare ranks the plans using one to five stars to indicate quality, with five representing excellence. The plans must offer the same coverage as Medicare’s Part A and Part B, but most offer additional benefits, such as dental and vision benefits. Supplemental benefits, such as dental coverage, are a key difference between Medicare Advantage plans and Original Medicare.

Most of the plans are HMO plans, however, there are PPO and fee-for-service plans available. Most Americans have a wide selection of different plans to choose from. The plans typically cost less than Original Medicare but have higher deductibles and may require you to use a doctor or hospital in their network.

According to the Kaiser Family Foundation, about 34 percent of Medicare beneficiaries chose Medicare Advantage over Original Medicare. Many of the Medicare Advantage enrollees have plans administered by UnitedHealthcare, Humana, or Blue Cross Blue Shield affiliates.

Some Medicare Advantage plans don’t offer any dental coverage beyond what original Medicare offers, but most offer at least coverage for preventative care. Plans with higher than average premiums may offer coverage for fillings, extractions, root canals and more. Seniors with Medicare Advantage plans with dental coverage typically pay a co-payment or a set fee for services. The number of Medicare Advantage plans with dental coverage differ greatly between states. For example, 79 percent of Medicare Advantage plans in Florida offer dental benefits,  according to AARP, while only 33 percent of Medicare Advantage plans in New Hampshire have dental benefits.

Will Seniors Benefit from Standalone Dental Insurance?

Senior citizens can benefit from both Dental Participating Provider Network (PPO) insurance plans and a Dental Health Maintenance Organization (HMO) plans sold by private companies. HMOs tend to be more affordable, but inflexible when it comes to your choice of dentists. If you don’t see your primary care provider, you’re not covered except for emergency care. PPOs are more expensive, but you can see a non-network dentist and have at least partial coverage. You can also see any dentist in the network, so you can change dentists anytime.

Dental care is usually divided into several categories for insurance purposes. There are preventative treatments, which are routine exams, cleanings and x-rays. Basic restorations are simple restorations, such as fillings and root canals. Major restorations include crowns and bridges. Most people have 100-80-50 coverage. This means the company will pay 100 percent of preventative care costs, 80 percent of the cost of basic restorations and 50 percent of the cost of major restorations. Some plans have fixed copay amounts instead of percentages to pay for services.

When deciding if a dental insurance policy is right for you, consider the annual cost, the amount of care you’re likely to need, the annual benefit limits, and the waiting period for certain procedures.

Group plans are more affordable than individual insurance plans. Seniors should check with professional or trade organizations where they are members to see if there is a group insurance plan they can join. A number of associations, such as the Freelancers Union and the Writers Guild of America qualify for group rate insurance.

What Are Dental Discount Plans?

A discount dental plan is where individuals pay an enrollment fee and an annual or monthly membership fee. In return, members receive discounted rates at dental offices participating in the plan. Typical services you can receive a discount on include:

• Routine checkups
• X-rays
• Dental cleanings
• Fillings
• Extractions
• Root canals
• Crowns
• Dentures

Discount dental plans offer numerous benefits over insurance including:

• No deductibles; you can use your discount card as often as needed.
• No restrictions on pre-existing conditions. Many insurance policies have missing teeth clauses, meaning you cannot fix a tooth that was missing prior to coverage and expect the insurance company to cover the cost.
• No waiting periods – insurance may have you wait up to six months for coverage for root canals or extractions. This may cause an existing condition to worsen.
• Discount plans accept everyone
• No annual benefits limit. This is important for seniors who need extensive care.

If you choose Smile Alliance Club or a similar plan, you may receive additional benefits for hearing and vision care. Discount dental plans are an affordable way for senior citizens to get dental benefits in East Detroit.

What Are the Ways Seniors Can Manage Out-of-pocket Dental Expenses?

Senior citizens on a fixed income have choices for dealing with out-of-pocket dental insurance expenses. Their dentist may offer payment options or they may qualify for a medical credit card such as CareCredit. These cards frequently offer promotions where you pay 0 percent interest for a specified time as long as the monthly payments are paid on time and in full. When the promotion is over, the interest is comparable to a regular credit card. Depending on your credit score, promotions can last six, 12, 18, or 24 months and the interest rate will vary.

Nearly all dentists accept major credit cards. And, you may be offered other financing options from a dentist office or provider, but seniors with less than very good credit won’t find many of these offers. Additionally, these financing plans can have very high interest rates, adding to the total cost of care if not paid in full quickly. Sometimes, it might be better to pay the interest rather than delaying necessary work. Small dental problems can turn into expensive problems quickly without prompt treatment.

Senior organizations, such as AARP, and other organizations, like those for veterans, are good sources of information regarding discounts on dental costs and insurance.