Dental Coverage

On almost every appointment, I am asked about extra dental insurance. If there was an outstanding stand-alone dental policy, then well over half of my clients would buy it. The fact is, I personally have not discovered such a policy that will be worth it to the majority of my clients. 

There are a couple of reasons for this:

1. Many dentist don’t take insurance. They do offer payment options (like a car loan in some cases), but  they don’t accept insurance payments or only accept insurance from a few companies.
2. Dentists don’t like being dictated to as to what they should charge or receive for their services. I can’t say that I blame them, but this is a big factor. 
3. As people get older, there’s a really good chance they may need major dental work. For an insurance company to cover the costs of major dental work, they’d have to charge way more for premiums and if they did that, then hardly anyone would feel it’s worth paying for.

Original Medicare and a Medicare Supplement DO NOT cover any routine or comprehensive dental. So, if you want extra dental coverage, then you need to look at purchasing a stand-alone dental plan.

Stand-alone dental plans: These plans primarily focus on and cover routine dental (exams, cleanings, X-rays) and some comprehensive dental (extractions, fillings, crowns, root canals, maybe some denture related items, etc.).     You may pay $20-50 per month for such coverage. You should only purchase one of these policies if:

• Your dentist is in the plans network or you are willing to use a network dentist.
• You will maximize the routine coverage by getting your typical two exams, two cleanings and some X-rays for $0 cost. That way you might break even on what you are paying for it.
• You are not relying on it to cover the majority of the costs for major dental work like crowns, root canals, and especially dentures. 

All dental plans put a limit on how much they will cover per year and that limit is typically ranges from $1,000-$2,000 per year.

Medicare Advantage Dental Coverage Options: Many Medicare Advantage Plans include additional dental coverage built into the plan. If that is the case with your plan, then that is typically all you will need. 

Some Medicare Advantage Plans offer dental as an Optional Supplemental Benefit that you pay an additional premium for. From my experience, these dental coverage options offer the most bang for the buck and are the most flexible to use. 

*Note: Some Medicare Advantage Plans offer a dental reimbursement benefit. That means, you go to a licensed dentist that accepts Medicare and you pay them and then  you submit the claim to the insurance company for reimbursement of allowed coverage.

Denture Coverage: Some dental plans will cover a little denture coverage, but don’t expect to get much out of it. If you need dentures, you are going to have to pay for most of, if not all of the costs yourself. In many cases that requires taking out a loan to pay for your dentures. How dentures can cost as much as a good used car is amazing!