Tips For Selecting Dental Coverage
Apr 20, 2012 - 9:50:37 AM
(HealthNewsDigest.com) - When I was growing up it was very common for people in their late sixties, early seventies to have dentures. But today, people are living longer and healthier lives, and older adults are more likely to keep their teeth for a lifetime than they were even a decade ago.
But, as most Medicare beneficiaries know, “Original Medicare” (Parts A and B) does not provide routine or preventive dental insurance coverage. Of course, there are some limited exceptions. For example, if a beneficiary has a medical emergency that involves teeth, original Medicare may cover those emergency costs, depending on what services are needed and who performs them.
But, when it comes to keeping your smile bright, the traditional dental coverage most people are accustomed to — cleanings, fillings, crowns and dentures — are not a part of basic Medicare coverage. Some Medicare Advantage (Part C) plans do bundle in dental coverage, but not all of them.
For that reason, many Medicare beneficiaries purchase stand-alone dental insurance coverage. However, dental insurance is generally not as comprehensive as traditional major medical coverage so it’s important to do your homework before purchasing a plan.
Here are some things Medicare beneficiaries should keep in mind:
Medicare supplement insurance plans don’t provide dental insurance coverage. If you have a medical emergency that involves your teeth, routinely Medicare Parts A and B (Original Medicare) may cover those emergency costs, depending on what services you need and who performs them. And, if Original Medicare covers your procedure, a Medicare Supplement Insurance plan is more likely to cover your out-of-pocket costs for that emergency. But, that supplement will not cover preventive dental services like cleanings, fillings and crowns.
Some Medicare Advantage (Part C) plans provide dental coverage. Many Medicare Advantage plans routinely provide benefits like dental and vision coverage. So, if you’re on a Medicare Advantage plan or considering enrolling in one, check to see if the plan provides routine or preventive dental coverage before you buy a separate dental insurance policy.
Be sure your dentist takes your plan. If you have a preferred dentist, find out what plans they accept before you enroll in a plan. Websites like eHealthInsurance, and the licensed agents in their call center, can help you search for plans with your dentist in them. Stand-alone dental insurance policies are typically going to give you a far better price for services performed by dentists in their network. Almost all policies use a tiered cost-sharing system, and you pay the least out of pocket for services when you use a dentist from the plan’s network.
Read the fine print. Most stand-alone dental insurance plans have cost-sharing requirements (co-pays, deductibles and coinsurance) so you should be sure you know how much you’ll spend for regular checkups or emergency dental work not covered by Medicare. And, expensive procedures like crowns and root canals may be subject to higher deductibles and co-payments than routine cleanings or fillings, depending on the plan you have.
Cosmetic dental surgery is almost never covered. Medicare beneficiaries should not expect an individually purchased dental insurance plan to provide coverage for cosmetic or elective procedures like teeth whitening or dental implants. There may be plans out there that provide those benefits, but they’re not the norm.
Only buy what you need. If you’re over age 65, chances are you don’t need braces. And, if you don’t need braces, don’t waste money on a plan that covers them. Stand-alone dental insurance policies come in all shapes and sizes. Some plans cover everything from braces to cleanings, while others cover a more limited set of benefits. Skipping the plans that offer dental benefits you don’t need could save you money.
Don’t wait for problems to arise. If you want to buy dental insurance on Monday and have major dental surgery on Tuesday, you may be disappointed. Most dental insurance plans have waiting periods for any major dental work so don’t procrastinate.
Selecting the medical coverage that’s best for you can seem overwhelming. But with a little time and research, you can find the dental plan that best fits your needs. And that’s something to smile about.
Ross Blair is President and CEO of Plan Prescriber, Inc. (www.PlanPrescriber.com ), a leading provider of comparison tools and educational materials for Medicare-related insurance products.
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