Original Medicare provides excellent coverage for seniors, but there are definitely some gaps: namely vision, hearing, and possibly most importantly, dental! Luckily there are many great dental plans for seniors available. Watch this video to learn about some of the most popular options.

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Original Medicare (Medicare Parts A & B) cover your basic inpatient and outpatient healthcare. However, it does not cover dental. Medicare supplement plans also do not cover dental. However, many Medicare Advantage plans do. Medicare Advantage, also known as Medicare Part C replaces Original Medicare and often encapsulates additional benefits such as vision, hearing, dental and more.

Positives:
Convenience & Cost

Negatives:
Limited options & Location Prohibitive

If you’re interested in a Medicare Advantage plan for dental coverage, first make sure that it meets your health needs. After that, thoroughly research the dental benefits to ensure that it is the right plan for you. You can only join, drop or switch a plan during the AEP which is every year from Oct. 15-Dec. 7 so make sure it’s the right plan for you!

Another option is private health insurance. Most dental insurance plans will run you between $15-$50 per month. You’ll also be responsible for your portion of covered services. There are several different types of plans to choose from. You’ve probably heard of PPO’s and DHMO’s (dental health maintenance organizations), but you may not have heard of Indemnity plans.

PPO’s and DHMO’s work very similarly to the way their health insurance counterparts do. HMO’s have relatively monthly premiums, but you must use an in network dentist. With DHMOs you will only be covered with in network dentists, but your copays are set. This makes determining your costs much easier. Additionally, DHMO’s require a “preferred” physician who must coordinate all visits with specialists. Also, some people report dissatisfaction with dentists in their DHMO networks. Because DHMO dentists must see a certain amount of patients, many patients feel rushed through their appointments and prefer the services of dentists that operate on a PPO. Of course, this is not true of all dentists. Some people absolutely love their in network DHMO dentist. With a DHMO, you may have a deductible you need to meet before your insurance kicks in.

PPO’s have higher monthly premiums, but you have more flexibility with dentist choice. If you use an out of network dentist, you will still have coverage, just less so than with an in-network dentist. With PPOs, most plans cover 100% of preventative services, 80% of basic services and 50% of major services. You still need to check with your dentist to determine your costs. Fees for the same services can swing widely even from county to county. For example, a root canal for a molar can range from $500 to $2000. That’s a pretty wide range! So, if you're flexible with your choice of dentist, you can certainly ask for prices and get a second opinion to make sure you’re not paying more than need be. Additionally, most plans will only pay up to $1000-$2000. After you have reached that cap, you will be on your own for any additional expenses! Luckily, most plans don’t count preventative services towards these maximums. There are also plans with much higher maximums. Additionally, like DHMOs, PPOs may have a deductible you need to meet before your insurance kicks in.


Then there are Indemnity Plans (also known as fee for services plans). These plans offer ultimate flexibility in the dentists and specialists you see and the coverage offered. Additionally, indemnity plans have much higher annual caps, so if you need extensive work, this may be a plan to pursue. However, these types of plans have higher monthly premiums and higher deductibles. You also have to pay upfront and then complete a large amount of paperwork before being reimbursed.

Additional options include dental savings plans (aka discount dental plans) or joining a spouse's plan.

If you have any further questions, please feel free to contact us here at iHealthBrokers at 888-410-0344 or [ Ссылка ]


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