Jordan Braverman, MPH
Dental care is rarely covered by Medicare… few retirees have dental insurance… and those who do have dental insurance often find that their coverage is very limited.
Dental bills average around $677 per year for the typical senior, and a major procedure, such as a root canal or a dental implant, can push that tab into four or even five figures.
Exception: Medicare usually will pay dental bills if they are related to a medical incident that requires a hospital stay, such as jaw reconstruction following a car accident.
Some resources that could help you dramatically reduce your dental bills or even provide dental care for free…
Insurance can help pay dental bills. Options to consider…
Dental insurance. If you have access to subsidized group dental insurance through an employer or former employer, it likely is worth having. If not, the case for dental insurance is less compelling.
Dental insurance typically features copayments as high as 50%… annual benefit caps in the low four figures… often long waiting periods before expensive procedures are covered… and usually only 80% coverage if your dentist is out of network. Dental insurance premiums for seniors are about $480 per year for individual plans. That’s a steep price for such limited coverage, but not necessarily an awful deal if you have reason to believe that you will require significant dental work within a few years, perhaps because your dentist has warned you that a major procedure cannot be put off too much longer.
If you do decide to sign up for dental insurance, consider the policies offered through AARP. Rates on AARP dental policies often are a bit lower than what comparable individual dental coverage would cost elsewhere.
More information: Visit AARP® Dental Insurance Plan
If you do have dental insurance, confirm that your dentist will accept it before agreeing to any procedure. Work with him/her to get the most out of the insurance if he does.
Example: If the dental work you require is not an emergency and significantly exceeds your coverage’s annual benefits cap, ask your dentist if the work – and the bill – could be spread out over two or more plan years.
Private health insurance. If you do not have dental insurance but have private health insurance in addition to Medicare, this health insurance could include some basic dental benefits. Read the plan literature or call the insurance company’s customer service department to find out.
Medical flexible spending accounts (FSAs). FSAs can substantially trim the effective cost of dental care by allowing patients to pay for health-care bills – including dental bills – with pretax dollars. Unfortunately for retirees, FSAs are available only to employees whose employers offer FSAs as part of their benefits packages.
Dentists’ bills often are negotiable – but only if you discuss costs before having the dental work done. Ask if you can get a senior discount or a cash discount if you pay in cash. Either of these appeals could net you savings of 5% to 10%.
Call other dentists’ offices to ask their prices for the procedure. If you find a better rate, tell your dentist that you are on a tight budget and ask if he can match the lower price.
Get a second opinion before agreeing to any major procedure. There’s a chance that your dentist could be recommending an expensive procedure that is not necessary. Have your dental files, including the most recent test results and X-rays, forwarded to the dentist who will provide this second opinion so that you do not have to pay to have these repeated. You will have to pay for the second opinion, but the cost of a simple office visit is so much lower than the cost of an elaborate dental procedure that it can be a smart investment if there is any chance that the original dentist was wrong.
IF YOU HAVE A LIMITED INCOME
You probably can get dental care even if your financial resources are very limited…
Medicaid. Medicaid is available only to those with low incomes and limited assets. Eligibility rules and program benefits vary by state. In most states, Medicaid provides at least basic dental care for those living near or below the poverty line.
To find out if you qualify, contact your state’s Medicaid Office. (Visit www.benefits.gov, select Medicaid/Medicare from the Benefits Quick Search menu, then choose your home state. Or call 800-333-4636 for a contact phone number for your state’s Medicaid office.)
Helpful: Nursing homes are legally required to arrange for dental care for residents who use Medicaid to pay for their stays. That typically means that they must either bring a dentist to the nursing home or transport the resident to a dentist’s office to receive care.
Local and state dental associations. Many have programs that provide dental services for free or reduced rates to those in financial need. Services are provided by dentists who volunteer their time. Eligibility requirements vary.
State and local dental associations can be found on the Web site of the American Dental Association (ADA), select “Dental Organizations” off the menu, then check both the “Constituent (State) Directory” and the “Component (Local) Directory” to find relevant associations. Or call the ADA at 312-440-2500 and ask for your state dental association’s phone number.
Example: The Connecticut Dental Association sponsors an annual “Mission of Mercy” program that provides free cleanings, extractions and fillings on a first-come, first-served basis. Unlike most programs of this sort, Connecticut’s Mission of Mercy does not require proof of limited income. See the Connecticut State Dental Association’s Web site for more information.
Public or nonprofit dental clinics. Available in many regions, these typically charge very low rates, perhaps linked to the patients’ ability to pay. In some cases, treatment is free. Your area Agency on Aging should be able to direct you to any dental clinics in your region and might know of other local low-cost dental options for seniors. (Call the US Administration on Aging’s Eldercare Locator, 800-677-1116, or use the Locator on the Web at www.eldercare.gov to find your local Agency on Aging if you cannot locate it in your phone book.) Your local or state dental association also might know of area clinics.
If you are too well off to qualify for low-income dental programs, consider these options…
Local dental colleges. Performed for perhaps half the usual cost, the work is done by dental students under the supervision of qualified instructors.
The quality of the dental care tends to be good… however, a dental school might not provide a full range of dental services. The American Dental Education Association Web site can help you find dental schools in your region. (At www.adea.org, click “About ADEA” then “Who We Are,” and “Predoctoral Dental Education Programs.”) Typing “dental schools” and the name of your state into Google.com also can help you find any schools in your region.
Retail dental centers. Usually located in shopping malls, they typically charge 10% to 20% less than traditional dentists’ offices.
Bottom Line/Retirement interviewed Jordan Braverman, MPH, former director of legislative and health policy analysis at Georgetown University’s Health Policy Center, Washington, DC. He is author of several books on health-care policy and financing, including Your Money & Your Health (Prometheus).