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Access to comprehensive dental care is critical to maintaining your oral and overall health. Dental care for seniors is no exception. Unfortunately, as of 2017, approximately 29% of seniors aged 65 and older had dental insurance, and approximately 66 percent of seniors had visited a dentist.¹
When you retired, you may have lost access to a dental plan you enjoyed for years through your previous employer. It can be challenging to find affordable dental insurance independently, leaving many seniors unable to afford the costly dental and periodontal care they need. Fortunately, there are affordable individual dental insurance plans for retirees to help you reduce the cost of going to a dentist and hep maintaining your oral health.
For seniors on Medicare, most dental care is not covered through Medicare Part A or Part B. However, you may be able to get dental coverage through a Medicare Advantage, Part C, plan².
Dental insurance is preventive care, you typically pay a small amount to get routine care like x-rays and cleanings. This allows you to maintain good oral health without paying a ton. Medicare, on the other hand, is set up as a health insurance plan, and like most health insurance plans, it is meant to be for major medical conditions rather than preventative care. Often Medicare plans have higher deductibles that you will have to meet before your insurance will kick in. Please visit https://www.medicare.gov/ for more information.
Dental insurance and medical insurance operate differently. Depending on your policy, dental care is often designed to be preventive, you typically pay a small amount for going in for routine visits and to receive care like X-rays, cleanings, and check-ups. Health insurance is typically designed to cover major medical and surgical costs. This difference may seem small but when you bundle dental and medical insurance, you may run the risk of paying more for your dental insurance than you would normally, even if the monthly premium is lower when bundled.
Another important consideration is that insurance companies that specialize in dental coverage often offer reduced rates that they have contracted for with network dentists. They also may have structures that allow them to process claims quicker.
Individual dental insurance may also offer more flexible plans in terms of deductibles and premiums. These plans also typically allow each individual to determine which services are most important to them and which are not.
No matter which plan you are purchasing, it makes sense to do research into your options before making a final decision. You should compare the monthly premiums, deductibles, and total out-of-pocket expenses before selecting a plan. The plan you choose should be flexible and fit your dental needs.
Unlike Medicare, there is no open enrollment period for applying for stand-alone dental insurance, you can apply year-round. This is great news because the sooner that you can get coverage the sooner you can save money on dental care costs.
Often companies will attempt to bundle dental plans with medical plans. Depending on your needs, this may not be convenient for you. When plans are bundled, typically it may come with limits to your overall coverage or high deductibles. When you purchase dental insurance plans separately it may be easier for you to control only buying what you need, rather than having it all lumped into a one-size-fits-all bundled insurance plan.
Purchasing an individual dental plan may also offer you a large provider network, giving you choices when it comes to who is taking care of your oral health. Many seniors have a long-standing relationship with their dentist, having access to a larger network means that you are less likely to have to change dentists.
People over 65 are at an increased for oral health problems, such as gum disease³, and without dental insurance, you might find yourself putting off treatment. Advancing age can bring all kinds of dental and periodontal (gum) issues, many of which need proper treatment to prevent further health issues that result from them. Having a comprehensive dental insurance plan is an important part of helping maintain oral health.
There are a few dental issues that typically impact seniors more than other people, these include:
Periodontitis (gum disease) - Gum disease impacts about 20% of seniors 65 and over.⁴ It is often perceived as a small issue and many seniors may ignore the symptoms associated with gum disease. This is a mistake. Periodontitis can cause teeth to loosen and fall out and, without treatment, can cause the underlying bone to be destroyed.⁵ The good news is that periodontitis is typically preventable with routine dental visits and good oral hygiene.
Tooth decay - As of 2018, over 90% of seniors over 65 have had a cavity permanent tooth and about 20% have untreated tooth decay⁶. Untreated decay can lead to other, more expensive, and painful issues like root canals and abscesses. However, teeth can be treated when you see the dentist regularly. Having dental insurance allows you to see your dentist for regular cleanings, allowing you to have small amounts of decay removed before it gets out of hand.
Oral Cancer⁷ - Oral cancer is a particularly dangerous form of cancer that is estimated to be responsible for over 10,000 deaths in 2020. The median age for diagnosing oral cancer is 63 years old. Like many oral health issues, cancer can typically be caught early with routine dental visits and it is one of the things that your dentist is looking for when you go in for your regular cleanings.
Unfortunately, brushing and flossing every day isn’t enough to ensure your oral health. A lack of preventive dental care may lead to unexpected tooth and gum disease, later on, leaving you with steep medical bills or debt from a costly but necessary procedure. Regular cleanings from your dentist help remove bacterial plaques that will eventually likely damage your teeth through cavities and decay. Even if you feel like your teeth are fine, you’ll benefit immensely from having an insurance plan.
There are two main insurance plan options that you’ll be able to choose from when you’re looking for affordable dental insurance as a retired senior citizen: PPO (Preferred Provider Organization) plans, and Dental Health Maintenance Organization (DHMO) plans.
PPO plans typically give you access to a wide range of dentists, and in some cases, you may be able to continue seeing providers outside the network. PPO members pay a monthly premium, and the plan covers a percentage of your costs after you’ve met your deductible. If you need individual health insurance and already have a dentist that you know and trust, PPO plans can be a good option.
DMHO plans require you to choose a single dentist or dental office as your in-network provider. If you need to see a specialist, like a periodontist or an oral surgeon, your primary dentist will give you a referral authorized by your insurance company. When you have a DMHO plan, you likely won’t have a deductible or an annual cost. Instead, you typically pay a copayment for any dental services you receive covered under the plan. This is typically an affordable type of dental plan, and many basic dental services typically don’t have a copay.
Whichever type of dental insurance plan you choose, simply having dental insurance can help reduce your cost to see dentists and specialists. You’ll have access to preventive care, making you less likely to develop serious problems like gum disease in the future. Dental insurance plans for seniors makes long term financial sense, and there are many options that are affordable for retirees.
The cost of dental plans for seniors depends on a few factors such as age and where they reside. As with other types of insurance, typically plans with higher monthly premiums often have lower deductibles and copays whereas plans typically with lower monthly premiums have higher deductibles and copays.
With many plans, prices may vary based on pre-existing conditions. Pre-existing conditions can raise your monthly premium. Many plans may also have a waiting period before procedures like cavities or root canals can be done. It is a good idea to enroll for dental insurance as soon as possible so that these pre-existing conditions do not develop, and you do not have to wait to receive treatment.
Regardless of your dental coverage needs, it is important that you have all of the information that you need related to insurance before you decide on the right plan for you. Guardian Direct® has a wealth of resources available to you so that you can make a smart choice that gives you the best coverage that you can afford.
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A comprehensive guide to dental insurance
Links to external sites are provided for your convenience in locating related information and services. Guardian, its subsidiaries, agents and employees expressly disclaim any responsibility for and do not maintain, control, recommend, or endorse third-party sites, organizations, products, or services and make no representation as to the completeness, suitability, or quality thereof.
Brought to you by The Guardian Life Insurance Company of America (Guardian), New York, NY. Material discussed is meant for general illustration and/or informational purposes only and it is not to be construed as tax, legal, investment or medical advice and is not intended to influence any reader’s decision to select, enroll in or disenroll from a Medicare plan.. This is not dental care advice and should not be substituted for regular consultation with your dentist. If you have any concerns about your dental health, please contact your dentist's office.
https://www.medicare.gov/what-medicare-covers/whats-not-covered-by-part-a-part-b, accessed January 2021
https://seer.cancer.gov/statfacts/html/oralcav.html, accessed December 2020
Brought to you by The Guardian Life Insurance Company of America (Guardian), New York, NY. Material discussed is meant for general illustration and/or informational purposes only and it is not to be construed as tax, legal, investment or medical advice.(exp.12/22)
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