As we grow in age, the list of our medical needs keep welcoming new items. If not for Medicare and its supplemental insurance plans, barely any of us would be able to afford our medical expenses and costs. Despite its merits, Medicare plans don’t cover dental care. If any of us seniors need to get a dental checkup, replace a tooth, or install a crown, we’re all on our own – or so we usually think. There are other options to get dental insurance on a Medicare plan. 

In this article, we’ll break down the options you have.

Dental insurance on medicare and medigap plans

Medicare insurance plans only cover some of the medical expenses, and they require a lot of copayments and deductibles. To solve this issue, Medigap plans were introduced. Just as their name indicates, these plans cover the gaps of coverage found in traditional Medicare plans. 

Despite the fact that Medigap has 10 different plans, it still doesn’t cover dental care, among other things. The only part of dental care that Medigap covers is the same part that Medicare plans cover; whenever there’s a medical need for it. They’ll only cover the medical part of dental care. To explain it further, they’ll cover the cost of extracting a tooth, but they won’t have anything to do with replacing it with another one. To get the best dental insurance for seniors on Medicare, you’ll have to choose one of three options. You can enroll in a Medicare Advantage Plan, get individual dental insurance, or join dental discount plans. On the other hand, if you’re a low-income senior, you might be eligible to get Medicaid, which can offer basic dental care coverage.

We’ll breakdown these options further. 

Dental insurance on medicare advantage plan

Medicare Advantage plans offer an alternative to having to supplement Medicare with Medigap. Instead, the plan offers comprehensive coverage on gaps present in the traditional Medicare plans, such as prescription drug costs, dental, and vision care. In this plan, you’ll pay a monthly premium depending on the level of insurance you need. Make sure to check the available plans carefully. Medicare Advantage plans differ widely on the premium paid and the dental coverage they offer. Most plans will limit their covering to cleaning, exams, and bitewing X-rays. They also have limits to their coverage which, if exceeded, you’ll be paying the rest out of your pocket.

Individual dental insurance 

Many seniors choose to get individual dental insurance, which offers them a wide range of covered services. 

In this plan, you can have coverage for many services, some of which are the following:

Type 1 services cover preventative dental care, such as:

  • Prophylaxis
  • Bitewing X-ray
  • Diagnostic Casts
  • Vertical Bitewings
  • Oral Evaluation

Type 2 services cover basic restoration dentistry, such as:

  • Films
  • Amalgams
  • Pain Treatment
  • Local Anesthesia
  • Nitrous Oxide Inhalation

Type 3 services cover major restorative dental care, such as:

  • Crowns
  • Pin retention and restoration
  • Sedative Fillings
  • Oral Surgery
  • Prosthodontics

Type 4 services cover orthodontic services, such as:

  • Braces
  • Implants
  • Teeth Pulling

While the variety of services are more comprehensive than those offered in a Medicare Advantage plan, dental insurance has low limits. The average annual coverage ranges from $1000 to $1500, which can easily be used up in a root canal and crown treatment. Most plans will also offer low or no coverage at all when it comes to Type 3 services (which seniors need the most) and Type 4 services. If your dental needs are extensive, then the best option you have is going for dental discount plans. 

Dental discount plans 

These plans are the seniors’ favorite for many reasons. For starters, they don’t require any downtime taken by the dental insurance to kick in. They require little paperwork and they bypass a lot of the hassle that comes with other plans, such as paying deductibles or having annual spending limits. That’s because of the fact that they aren’t really insurance plans; they offer discounts for dental care for their members. 

To get your membership, you pay an annual membership fee, after which you have access to a full network of dentists who provide discounts on their services. The discount can range from 10% to 60%. 

With the lack of dental coverage provided by Medicare or Medigap plans, seniors need to look elsewhere to take care of their dental health. They can get some dental coverage if they qualify for a Medicaid program, but that’s not for everyone. They basically have 3 options: they can enroll in a Medicare Advantage plan that covers basic dental care, they can get individual insurance coverage, but it will have low limits, or they can join a dental discount plan.