By Susan Stewart, Licensed Insurance Agent
In a perfect medical world, everyone would have access to all the dental care they need. Why is dental care important? Especially for seniors?
According to an article by Robin Schiltz for Senior Safety Advice, good dental care can help prevent common oral diseases. Systemic health connections with periodontal disease have been linked to cardiovascular disease and diabetes. Bacteria from gum infections and cavities flow into the bloodstream. Proper chewing and nutrition are important to physical and mental health. I hear clients say how they long to eat an apple or chew a steak. Both nutrition and the joy of food are lost. Who wants applesauce instead of a crisp, juicy apple? Who wants another scrambled egg when the body longs for a steak?
But for seniors, dental care is considered optional. Non-medical. Carriers offer it to us through Medicare Advantage plans as a bonus benefit that lures people to enroll in Medicare Advantage. Original Medicare Parts A and B do not cover regular dental care—at all. A Medicare Supplement doesn’t offer dental as part of “medical” care either. Even in the workplace, a robust dental plan is hard to find. Just to have your teeth cleaned can cost between $120 and $300 out of pocket, depending on how long it’s been and the condition of the teeth and gums. When I googled the cost of a cleaning, I was surprised that most of the results talked about purchasing dental insurance. Comprehensive dental care can quickly run into the thousands of dollars if you need a bridge, crown, or dentures. Implants are coming down in price but remain too expensive for most to consider.
I don’t understand why being able to eat, chew, and smile isn’t “medical” care. I also understand that if you are already on a tight, fixed income, paying for anything that isn’t urgent often gets delayed.
I’ve learned from my clients that they don’t even use their dental benefits. Why? It can be challenging to find an in-network dentist. Primarily, however, they feel worried about not understanding their benefits and getting a surprise bill. I suppose that we don’t think about our teeth unless they hurt? Or have we just spent a lifetime without good dental care, so it just doesn’t come to mind on a day-to-day basis?
Whether your dental coverage is in a Medicare Advantage plan or whether you purchase a separate plan on the side, consider:
You may need to find a new dentist to keep money in your own pocket. It’s hard to let go of a provider that one likes, but if the difference is 80 percent coverage for a filling or 20 percent, that adds up.
Cross-check that your dentist is in network. This is key. Not participate. In network. A client went to a dentist who participates, but she had to pay the difference between the charge and what the plan paid. Ouch. If she had stayed in network, her cost would have been $0.
Require clarity of your cost before you ever sit in the dental chair. Dentists must get pre-determination of coverage for costs over $300. They want to know what your plan will pay. Be assertive in your requirement for clarity.
If you have no dental coverage, consider getting it. Premiums with lower benefits are smaller than premiums with maximum benefits, but if the benefits can outweigh the cost of the premium, you’re already ahead.
Be mindful and proactive in taking care of your mouth. Keep your teeth clean and flossed. Dentists recommend spending 30 seconds on each of the four quadrants in your mouth: top front, top back, bottom front, and bottom back. Rinsing with warm saltwater kills bacteria. Just those two small, low-cost disciplines assist in long-term oral health.
If you have any dental coverage at all, use it. Plan it. Prioritize it. Your body and mouth will thank you.
