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A Comprehensive Guide to Dental Insurance, Discount Dental Plans, and Medicare Advantage in Bloomington
Years of wear and tear, chronic health conditions, and even dental neglect can take a toll on our oral health as we age. Although seniors are the segment of the population most likely to experience extensive dental issues, they are also the least likely to have access to affordable dental benefits. Although two-thirds of seniors have no dental coverage, adults over the age of 65 still have the highest growth rate of dental spending, and the trend does not appear to be slowing. According to statistics from the American Dental Association Health Policy Institute, the number of annual dental visits by seniors increased by 6 million between 2006 and 2016. In all, dental spending by seniors totaled more than $28 billion in 2016. In order to avoid straining what may be an already tight budget, seniors must consider their options for dental benefits.
Without dental benefits in Bloomington, the cost of even basic dental procedures can be out of reach for many seniors. According to a report by the Kaiser Family Foundation, 19% of seniors who received dental treatment in the past year reported spending at least $1,000 out of their own pocket. Although the cost of a particular dental procedure can vary from patient to patient and practice to practice, the following is an overview of the average cost of common dental procedures.
Checkups and Cleanings:
- Basic exam–$50 to $100
- Dental X-ray–$20 to $250
- Standard cleaning–$70 to $200
- Silver amalgam–$50 to $300
- Composite–$90 to $450
- 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
The cost of a crown can range from $500 to $3,000 based on the type of material used.
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 Alternatives Do I Have for Dental Benefits in Bloomington?
If you have recently retired or turned 65, you may find yourself among the 65% of seniors without dental benefits. Since most Americans get their dental coverage through their employer, they lose that coverage once they leave the workforce. Since traditional Medicare only covers dental services under limited circumstances as part of Part A hospital benefits, you can’t rely on Medicare to pay for routine exams and cleanings. About one-fourth of seniors receive dental coverage through a Medicare Advantage plan. Another 10% turn to private insurers.
Are Dental Benefits in Bloomington Included in Medicare Advantage Plans?
Medicare Advantage plans offered by private insurers, such as Humana, Aetna, and UHC, are optional plans that you can purchase to supplement the benefits provided by traditional Medicare. Unlike Medicare where reimbursement comes from the federal government, reimbursement under Medicare supplement plans comes directly from the insurer. It also means that you will receive two ID cards: one for your basic Medicare and one for your supplement. Most supplement plans have relatively low premiums. According to MedicareAdvantage.com, the average yearly premium in 2018 was around $420. You also get the benefit of out-of-pocket spending caps, low deductibles, and access to a preapproved network of providers. In addition to benefits for basic dental services, such as exams, cleanings, and X-rays, most plans also offer benefits for prescription drugs and vision and hearing services.
How Much Does Dental Insurance Cost?
Although premiums can vary based on the level of plan that you choose, a Bankrate survey found that the average standalone dental insurance plan costs around $350. This is quite affordable In general, private dental plans offer tiered coverage based on the type of service. For example, your biannual exam may be covered at 100%, a filling at 80%, and a crown or root canal at 50%.
Basic Dental Plans:
Similar to Medicare supplement plans, most entry-level dental plans limit coverage to prophylactic procedures, such as basic exams, routine cleanings, and standard X-rays.
Mid-Level Dental Plans:
If you require expanded coverage for fillings, orthodontics, specialized X-rays, emergency treatments, dentures, and inhalation anesthesia, then a mid-level dental plan may work for you.
Premium Dental Plans:
Although they come with the highest premiums, a top-tier plan may make financial sense for seniors with significant oral health needs. These plans typically cover restorations, dentures, endodontic and periodontic procedures, and oral surgery.
You will likely pay a little less for a standalone dental plan than a Medicare Advantage plan, but you also will not get the additional hearing, vision, or prescription benefits.
Are Dental Discount Plans a Good Alternative to Standalone Dental Insurance?
If you are looking for an alternative to traditional insurance that can help you save money on basic dental services, a dental discount plan may be a good option. These plans are sold by private companies, not insurers, that negotiate lower rates for services with participating dentists. Rather than a monthly or annual premium, plan members pay an enrollment fee and membership fees that are far below the premium of even a basic insurance plan. Members then pay the dentist directly at the predetermined rate. Everything is negotiated by the provider ahead of time, so there are no surprises. While you may get more comprehensive benefits with a traditional insurance plan, a dental discount plan will still save you between 20% and 80% on the most frequently used services, including:
- Routine cleanings
- Basic exams
- Root canals
- Standard X-rays
Even though discount plans offer tremendous savings, you may still be better off investing in private insurance if you have extensive dental issues.
Since DentRite® and other popular discount plans also include discounts for hearing, vision, and pharmacy services, you get even more for your money than most insurance plans. Many consumers also turn to discount plans because of their flexibility and convenience. For example:
- You can use your benefits as often as you want during the year.
- Prices are set in advance, so you don’t have the hassle of filling out claim forms.
- There are no hidden out-of-pocket fees or deductibles for dental care.
- There are no exclusion periods, so you can take advantage of your benefits right away.
- You can see any dentist in the country that accepts the plans or change dentists at any time. You can also change your dentist at any time.
- If you have been denied insurance coverage because of your age or preexisting conditions, a discount plan may be your best option since acceptance is guaranteed.
- Most plans allow you to add family members.
- Most plans allow you to receive a full refund if you cancel your membership within 30 days.
How Does Dental Care Financing Work for Dental Expenses?
Dental financing makes it possible to spread the cost of your dental treatment over a number of months. For example, CareCredit offers financing options ranging from 24 to 60 months and is accepted by more than 200,000 providers and facilities across the United States. Of course, the application process considers income and credit history, so some patients do not qualify.
You can also check senior advocacy organizations, such as AARP, for more information. They often have information and resources regarding insurance options and discounts for seniors.