Many seniors don’t have dental coverage as part of their Medicare or employer-sponsored health insurance plan, so paying an additional premium for dental insurance is usually worth the extra cost. Typically, health care insurance plans don’t cover visits to the dentist at all, while dental insurance covers some, though not all, of the costs associated with oral wellness. If a person suddenly needs unanticipated dental work, the costs can add up rapidly. When seniors pay for dental coverage, insurance provides peace of mind and less of a shock to the budget, especially for those who are on a fixed income.
Why Dental Insurance Is Important for Seniors
Seniors generally require more dental care than younger people. They may be taking medications that cause dry mouth, which can lead to tooth decay. Older fillings and other dental treatments may have degraded over time, requiring replacement. Preventive visits to the dentist twice a year are important for overall health and often include cleanings, examinations and X-rays, all of which are costly. With dental insurance, seniors can choose the plan that best suits their budgets and needs as they save on biannual or more frequent oral healthcare visits.
What Dental Insurance Covers
Seniors can choose from a variety of dental insurance plans. The monthly premiums vary depending upon what’s covered, the copay and deductible amounts, annual maximums, waiting periods before the insurance goes into effect and whether in-network or out-of-network dentists can be used.
Most dental insurance plans cover:
- 100% of the cost of semiannual cleanings, exams and X-rays
- Topical fluoride treatment
- Fillings for cavities
- Crowns
- Root canals
- Tooth extraction
- Emergency care (such as chipped teeth, infections)
Of course, there are differences in what each dental insurance covers and charges in terms of copays and deductibles.
Most dental plans use something called the 100/80/50 cost-sharing model to determine coverage costs. For plans adhering to this model, preventive services, such as cleanings, exams and X-rays, are covered 100% by insurance. Basic services, such as fillings and root canals, are 80% covered, while insurance carriers pay 50% of costs for major work (bridges, crowns).
More comprehensive plans, which likely come with higher premiums, may cover:
- Orthodontic work (bite corrections)
- Periodontics (gum disease treatment, implants)
- Prosthodontics (dentures)
Some plans require a waiting period before coverage for certain dental procedures can begin. These waiting periods may be as long as a year or two, making it important for seniors to plan ahead with regard to obtaining dental insurance, especially if oral issues are anticipated.
The majority of dental plans don’t cover cosmetic dental services, such as veneers or teeth whitening.
Costs for Dental Coverage
Depending on the state a senior lives in and the specific dental insurance plan, the monthly premium varies. On average, most dental insurance premiums range between $15 and $50 per month, although those numbers can be much higher in certain areas and when purchasing full-coverage plans.
It’s important for seniors to keep up with their oral health care needs, as preventive services covered by dental insurance can help seniors avoid higher costs associated with major dental issues that crop up as they age. Regular dental care and treatment without insurance can get expensive if paying for it out-of-pocket. Dental insurance helps seniors enjoy better oral health and avoid major expenses in the future.
