(845) 512-1219

Ramapo Dental Care
29 N Airmont Rd, Suite 2, Suffern, NY 10901

Medicare Advantage Dental Benefits in Suffern

The Truth About Dental Expenses and Medicare Advantage in Suffern

From the natural effects of age to years of neglect, there is no question that we are more likely to experience dental issues as we get older. Even though they are the portion of the population most likely to need dental services, seniors also have the fewest options when it comes to affordable dental benefits. Despite the lack of benefit options, seniors spent nearly $28 billion on dental services in 2016. The rate of dental spending among seniors increased faster than any other demographic. A study by the American Dental Association Health Policy Institute found that 6 million more seniors sought out dental services in 2016 than in 2006, and the trend shows no signs of slowing down.

Going without dental benefits in Suffern can negatively affect your oral health and create a significant financial burden if you should experience a dental emergency. According to the Kaiser Family Foundation, approximately half of all seniors did not receive dental services during the past year, and 19% of those who did see a dentist ended up spending more than $1,000. The following are examples of what you might pay for common services and procedures without dental benefits in Suffern.

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.

Can Seniors Get Dental Benefits in Suffern?

Seniors are forced to look for alternatives for dental coverage once they turn 65 or leave the workforce. Most people get their dental coverage through employer-sponsored dental plans. This coverage automatically ends upon retirement. Upon turning 65, all seniors are covered by traditional Medicare, which typically does not cover any type of dental services. Medicare will only cover basic dental services under Part A hospital benefits when they are required for another covered procedure, such as clearance for a covered surgery. Currently, about 65% of seniors do not have dental benefits, and the percentage is increasing rapidly with the aging of the baby boom generation. Twenty-five percent of seniors receive dental coverage through Medicare Advantage plans, and approximately 10% purchase a dental plan through a private insurer.

What Are Medicare Advantage Plans?

You can expand your basic Medicare coverage by purchasing an optional Medicare Advantage supplement. These plans offer a range of benefits, including:

  • access to a network of qualified providers,
  • limits on out-of-pocket expenses, and
  • low deductibles.

These plans are offered by private insurers, such as Humana, Aetna, and UHC. This means that providers are reimbursed directly by the insurer rather than the federal government. It also means that you will receive a separate ID for your supplement in addition to the red, white, and blue one that you receive for your traditional Medicare. Most Medicare supplement plans include benefits for vision and hearing services, prescription medications, and some dental services. If you have extensive dental issues, a Medicare supplement may not provide enough coverage since benefits are normally limited to exams, cleanings, and routine X-rays. As of 2018, the average cost of a Medicare supplement was around $420 per year.

Is Standalone Dental Insurance Affordable?

According to Bankrate, you can expect to pay an average of $350 per year for a standalone dental insurance policy. This is slightly less than the average Medicare Advantage plan; however, you do not get the added hearing, vision, and prescription benefits. The majority of private dental insurance plans provide tiered coverage. For example, your annual dental exam may be covered at 100%, your filling at 80%, and a root canal at 50%. Most insurers allow customers to customize their dental insurance by offering various levels of coverage at different price points.

Basic Dental Plans:

Similar to Medicare supplements, an entry-level dental plan normally covers prophylactic services, including basic exams, routine cleanings, and diagnostic X-rays.

Mid-level Dental Plans:

For a slightly higher premium, you can purchase a mid-level plan that includes more benefits. In addition to the prophylactic services included in most basic dental plans, mid-level plans also include coverage for orthodontics, dentures, fillings, panoramic X-rays, emergency treatments, and inhalation anesthesia.

Premium Dental Plans:

Premium dental plans are designed for individuals with significant dental issues. The higher premium gives you access to coverage for advanced dental procedures, including:

  • Full or partial dentures
  • Inlays and onlays
  • Crown restorations
  • Oral surgery
  • Endodontic procedures
  • Periodontal procedures

When considering your insurance options, it is important to find a balance between your anticipated dental needs and your budget. For example, a premium plan may be overkill for someone in good oral health since they would be paying for benefits that they are unlikely to use.

What Are Dental Discount Plans?

If you are looking for a way to lower the cost of cleanings and other routine dental services, then a dental discount plan may be a viable option. These plans are sold by private companies, but they are not insurance. The company negotiates on behalf of members to secure discounted rates from participating providers. In exchange, you pay the plan provider a small enrollment and monthly membership fee. You know exactly what you will pay up front, and there are no claim forms to fill out. Although discount plans do not offer the comprehensive coverage found with traditional insurance, they can still lower the cost of common services, including:

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

DentRite® and other discount plans also normally include discounts for other health and wellness services, such as vision, hearing, and prescription medications. Other reasons to consider a discount plan include:

  • Your acceptance is guaranteed regardless of your age or preexisting conditions.
  • You don’t have to worry about deductibles or additional fees.
  • You can change providers at any time.
  • There are no limits on the number of office visits.
  • There are no waiting periods before receiving your full benefits.
  • You can add family members to your plan.
  • You are able to use your benefits at any participating dentist.
  • You can cancel your membership within 30 days and receive a full refund minus a small processing fee.

Discount plans work well for individuals who are in relatively good oral health. A comprehensive dental plan may be your best bet if you anticipate needing major dental work.

Is It Possible to Finance Dental Care?

Many dental practices allow patients to pay for their treatment over time. One popular financing option, CareCredit, is accepted by more than 200,000 providers and health and wellness facilities across the country. Most medical credit providers offer both short-term and long-term financing ranging from two years up to five years depending on the amount being financed. Many medical credit companies also offer promotional financing periods with no interest as long as you pay the full balance by the end of the promotional period. Keep in mind, however, that if you don’t pay the full balance in time that the accrued interest will be added to your balance. There are a couple of factors to keep in mind when financing medical expenses:

  • Just like any other form of credit, you do have to meet credit qualification criteria.
  • You can expect to pay 15% to 20% interest, which can increase your final cost significantly.

Finally, you can often find information regarding dental care insurance options and discounts geared specifically for seniors through AARP and similar organizations.

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Ramapo Dental Care

29 N Airmont Rd, Suite 2, Suffern, NY 10901

(845) 512-1219

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