Older adults, namely those 65 years and over, are part of a quickly growing group of people in the United States. They’re also the most at risk group of people in regards to dental health.
And get this: a very small number of retired folks have any form of dental coverage.
The reason this age group is most at risk for dental problems is because our bodies tend to break down and deteriorate — including our teeth — as we age. This is why regular visits to the dentist are crucial as we get on in years.
What are the potential dental problems for those 65 and older? Here are a few:
- Dry mouth
- Root decay
- Gum disease and infection
- Tooth loss, which can lead to an uneven jaw bone
- Inflammation of gum tissue from dentures
- Oral cancer
If someone experiences any of these issues, that can lead to more issues. And eventually, they can negatively affect the standard of living for that person, including chewing, talking, and even focus.
How Does Dental Coverage For Seniors Work?
With as many dental coverage options as there are, it’s surprising how many people don’t have any sort of coverage. If you’re one of those people without coverage, here are a few options for you to consider.
Dental Coverage Through The Affordable Care Act
Many of the standard health insurance plans in the Marketplace don’t include dental insurance, but you can purchase those in addition to medical insurance. In fact, many states require you buy medical insurance if you want a dental insurance plan. And for these stand-alone dental plans, federal subsidies (i.e. financial aid) are not available.
The ACA may not provide the best dental plans for seniors, but it is a viable option.
Dental Coverage Through Medicare
Medicare provides health insurance to tons of adults 65 years and over, but it does not offer coverage for basic dental care. The only time Medicare could help pay for dental services is if the care is considered a medical need. (Something that can help supplement Medicare is Medigap, a type of private insurance plan. But it also doesn’t offer dental coverage).
However, Medicare Advantage (aka Medicare Part C), a health plan offered by private companies, does have dental benefits.
If you end up getting Medicare or already have Medicare, you should know that you’re legally permitted to also have a dental plan through the Marketplace. And sadly, this process is not always convenient.
Dental Coverage Through Medicaid
Medicaid offers medical and dental coverage for low-income U.S. citizens, including senior citizens.
States can include dental coverage in the Medicaid programs they offer, or not. And even if a state does offer dental benefits, the coverage can vary widely.
To get an idea of what your state offers, you can check out this map of the U.S. that shows what level of dental coverage each state offers.
Dental Coverage Through Dental Savings Plans
One option that many people overlook and underestimate is getting a dental savings plan (aka a discount dental plan). These plans are separate from senior dental insurance and work in a more convenient way for the patient.
Basically, you pay a small annual fee instead of a high monthly premium and you can get up to 60% off each dental visit. And the nice thing is that you don’t have to complete any paperwork because everything is done online. You don’t have to file a claim, or wait for a reimbursement. Plus, there are no deductibles that you need to meet and no annual spending limits you have to reach before getting discounts.
In fact, it doesn’t matter if you have insurance at all. These discount plans are always available to you.
Dental Insurance Vs. Discount Dental Plans
Dental insurance plans for seniors are great — they can cover a plethora of dental services with a lot of options for where to go for care. But the tradeoff is that it’ll cost you a pretty penny.
With dental insurance, you pay a monthly premium, which can add up to hundreds or even thousands of dollars per year. Then when you visit the dentist, you usually pay the dentist for the services out-of-pocket as well as a copay.
Then you have to file a claim to the insurance company for a reimbursement of the out-of-pocket expenses (not the copay). If the insurance company approves the claim, then you have to wait for your check in the mail. This whole process can take weeks, all while you’re out the money you paid the dentist.
On the other hand, a discount dental plan can save you more money with less of the hassle. With one of these low-cost dental plans, you get a membership card that you show when you visit the dentist. The dentist’s office applies your discount right then and there, after which you pay for the discounted services. And instead of paying a high monthly premium, you pay a low, fixed annual fee that’s usually less than $100.
These plans are a great dental care option for seniors with or without insurance.