Surprisingly, Medicare has very little dental coverage and with over 48 million people using Medicare as their primary insurance, this is a big deal. Original Medicare, Parts A and B, does not pay for cleanings, dentures, fillings, or any other routine dental procedure. You may receive coverage if you happen to be enrolled in a Medicare advantage plan. If you have Medicaid, some services may be covered and if you’re confused about the difference between the two programs, click here. However, you need to verify, as each advantage plan is unique. It’s not as if seniors stop needing dental care, but with tight budgets and no help from Medicare, many seniors are forced to ignore their oral health.
Although it may seem like you’re saving money in the short term, disregarding dental care can lead to complications (beyond your mouth) later down the road. Poor oral health increases the risk of heart disease by 180% and the risk of stroke by 300%. It’s undeniable that dental care is extremely important, but where can seniors turn for help?
If paying for dental insurance is not an option, below are five resources seniors should investigate.
For Californians specifically, certain services are covered under Denti-Cal which is a benefit provided under Medi-Cal. This is an improvement from recent years and was reinstated on May 1, 2014. They’ll cover exams and x-rays, cleanings, fluoride treatments, fillings, root canals in front teeth, prefabricated crowns (stainless steel or tooth colored), full dentures, or other medically necessary procedures. Beyond these services though, seniors must either pay out of pocket or buy dental insurance.
- Tooth Wisdom:
Tooth Wisdom is a health resource website for senior citizens. They have compiled a comprehensive resource guide organized state by state. Click the interactive map for each state’s unique programs. After clicking on the map there will be a dental care option to click on, which will list low cost oral health options if you do not have dental insurance. Click here for the website.
- Dental Schools:
If you clicked through Tooth Wisdom’s guide you will have seen that many of the sites they list are dental schools. Dental schools offer high quality care at reduced price. Students will perform procedures, but the students are under strict supervision and the cost is far less than what you’d pay at a private practice.
- Dental Life Line:
Dental Life Line is a nonprofit that strives to provide dental care and education to people who cannot afford it. They only serve people that meet one of these conditions: have a permanent disability, are 65 or older, or who are medically fragile. Their main program is called Donated Dental Services (DDS) and over 15,000 volunteer dentists provide care. Follow this link to view an interactive map to see which programs are available in your state. It is worth noting that eligibility varies by state.
- Discount Dental Plans:
Discount dental plans, also called dental savings plans, are not the same as dental insurance. Discount dental plans have low monthly payments. As AARP puts it, dental savings plans are similar to a Costco membership, meaning you pay a fee for the access to discounted services. This type of plan gives members access to discount dental care with no deductibles, no caps on annual coverage, and no claims paperwork. In addition, when applying for a discount dental plan, pre-existing conditions are not a problem.
Dental savings plans make the most sense for people who would like routine dental services, but don’t want to pay the full costs out of pocket. Discount dental plans also include cosmetic dentistry, which is excluded from most dental insurance plans. For larger procedures, however, this option may not make sense because you have to pay for the service in full, or negotiate the price with the provider with no reimbursements from the plan. Although it is discounted, it is far from free.
Finding and receiving oral healthcare is difficult, if not impossible for many seniors across America. Until the federal government mandates rules that extend to all states, dental care will be determined by which state you live in. Fifteen states have nearly comprehensive coverage, 16 states have limited coverage, 14 states have emergency coverage, and Alabama, Arizona, Delaware, Maryland, and Tennessee have no senior coverage at all. DentaQuest, a research group and administrator of dental insurance, found that in America we spend as much on dental diseases—most of which are avoidable—as we spend on the total cost of all cancer treatments combined. With this magnitude of spending hopefully a change is due, but for now, use the resources above to locate the best care possible.
Max Gottlieb is the content manager for Senior Planning. Senior Planning is a free service intended to help seniors and their families navigate through the often-complicated process of obtaining benefits and long-term care.