Medicare Advantage dental benefits in Fond du Lac (Seniors 65+)

Overview of Dental Insurance Options for Seniors

People diagnosed with chronic kidney disease, anyone over the age of 65, and people who are permanently disabled are all eligible for Medicare benefits. Once someone reaches the age of 65, he or she is enrolled in this government service. If you're eligible for receiving Medicare, you may not be aware that it doesn't provide coverage for most dental services, such as extractions, cleanings, exams, and fillings. This can leave many individuals without a way to pay for dental care. Fortunately, individuals can choose from a discount plan, a Medicare Advantage plan, or private insurance. Seniors and other Medicare beneficiaries can also get in touch with us to learn more about dental benefits in Fond du Lac.

If you don't have dental benefits, comprehensive coverage or other dental care plans, you can refer to the following list for an estimate of what you can expect to pay on your own.

Checkups and Cleanings:

• Basic exam–$50 to $100
• Dental X-ray–$20 to $250
• Standard cleaning–$70 to $200

Fillings:

• Composite–$90 to $450

Extractions:

• Simple extraction–$75 to $450
• Surgical extraction–$150 to $650

Crowns:

The cost of a crown can range from $500 to $3,000 based on the type of material used.

What Should I Know About Medicare Advantage Plans?

A Medicare Advantage plan is an optional insurance plan that expands on the coverage provided by basic Medicare. The plans are offered by private companies, such as Humana, Aetna, and UHC, and most plans offer coverage for prescription medications, hearing, vision, and dental benefits.

Beneficiaries of a Medicare Advantage plan are able to utilize services from a wide range of network providers, and most plans have low premiums, deductibles, and limits on how much you'll pay out of your own pocket, in addition to other price protection and cost-sharing measures. Traditional Medicare is subsidized and sponsored by the government, which is how healthcare providers receive reimbursement for services provided. Unlike traditional Medicare, benefits of a supplemental plan are paid by private insurers to your dental care provider.

Members of these supplemental plans can expect to receive an ID card from their insurance company. This ID card is separate from the blue, red, and white card issued by traditional Medicare. The low yearly premium required by these supplemental plans makes it an ideal option for seniors. However, benefits are usually restricted to preventative and basic services, including cleanings, exams, and x-rays. Based on estimates from the Centers for Medicare and Medicaid Services, beneficiaries of Medicare Advantage plans in 2019 can expect a monthly premium of about $28.00.

Should I Choose Standalone Dental Insurance?

Standalone dental insurance from a private company comes in a variety of coverage types and price levels, and they can be customized to meet the needs of most people, whether you only need basic preventative services or more complex treatment.

Basic Plans:

If you're looking for the cheapest standalone insurance, a basic plan might be for you. These plans offer coverage for x-rays, cleanings, professional exams, and other prophylactic services.

Mid-level Plans:

For a wider range of services, you might choose a mid-level plan. In addition to the preventative services offered by the basic plan, a mid-level plan also provides coverage for specialized x-rays, orthodontic treatment, dentures, emergency treatment, inhalation anesthesia, and fillings.

Premium Plans:

Although premium plans have the most expensive monthly or yearly premiums, they also offer the most coverage, including partial coverage for advanced procedures, such as:

• Treatment for gum disease, such as endodontic and periodontal procedures
• Oral surgery
• Complete or partial dentures
• Crowns
• Dental restoration services, including inlays and onlays

Most forms of standalone insurance offer tiered coverage known as "100-80-50." As an example, this means that routine procedures such as cleanings and exams are usually covered 100%, fillings and other basic dental work are usually covered at 80%, and complex procedures are usually 50% covered.

Your monthly or annual premiums for standalone insurance depend on which type of coverage you receive. While standalone plans offer more coverage than a Medicare supplement plan, they generally don't offer coverage for hearing, vision, or prescription medications.

Options for Managing Out-of-pocket Dental Expenses

If you have to pay out-of-pocket for dental services, there are ways that can help make the cost of care more affordable. Many dental practices flexible financing options and payment plans to qualified individuals. In addition, patients can also apply for CareCredit, a financing program for a variety of dental and medical services. CareCredit is very similar to a credit card and is accepted by more than 200,000 providers nationwide.

For smaller balances, some medical credit providers offer short-term financing options for up to two years. If you have a larger balance, it's possible to receive long-term financing for up to five years. Many of these programs have special promotions where applicants can receive financing without any interest when the balance is fully paid before the promotional period ends. However, as part of the application process, your credit history will be reviewed, so not everyone will qualify. Financing programs can also have high-interest rates at 15% to 20%.

Senior organizations, like the American Association of Retired Persons (AARP), can provide information about special rates for seniors and different types of insurance. To learn more about dental benefits in Fond du Lac, call our office today to speak with a member of our helpful team.