Enrolling for Medicare can be a confusing experience. There are many considerations to keep in mind when evaluating the best coverage for your needs.
Medicare does not cover general dental insurance, leaving many seniors with the task of finding supplementary coverage. Here are some things everyone needs to know about Medicare, what dental services are covered, and how to choose the best plan.
What Do I Need To Know About Medicare?
Medicare is divided into four parts: Part A, Part B, Part C, and Part D. Part A and Part B coverage is encompassed during the initial enrollment period, which spans the three months leading to and following an individual sixty-fifth birthday. These parts cover inpatient and outpatient care, such as a hospital stay, surgery, and diagnostic tests.
Part C is a private insurance option that covers Part A and Part B with additional coverage, such as vision and dental. Eligible parties can pay for private Part C Medicare and reap the benefits of clearly outlined out-of-pocket costs and coverage guidelines.
Finally, Part D is another add-on through private insurance that specifically covers prescription medication.
When enrolling in Medicare, it is best to get the job done as soon as possible during the initial enrolment period. Doing so ensures consistent coverage and no penalty fees. It is also important to understand what basic Medicare covers and where you will need supplemental insurance.
What Dental Services Does Medicare Cover?
Contrary to popular belief, basic Medicare does cover some dental services. However, these services are only covered when they are a subset of another issue and do not cover basic care.
For example, if you are in a terrible accident and require jaw surgery or emergency dental work, Medicare would cover some of those costs. Additionally, many cancer treatment protocols require dental work before treatment. This process could include the extraction or correction of damaged teeth as chemotherapy increases the risk of infection in the body.
In some cases, Part A and Part B Medicare will contribute to the cost of your hospital stay if dental surgery is deemed medically necessary. However, it will not cover the treatment itself.
So, while some dental is covered by basic Medicare, cleanings and fillings are not. Furthermore, dentures are not covered under basic Medicare— an important consideration with age.
Five Tips For Choosing The Best Dental Plan For Seniors
Choosing the right dental coverage requires time, research, and comparisons. Here are five essential tips for finding the right plan for you.
Evaluate Your Current Needs
First, take a look at your medical history as it relates to oral health. If you have struggled with dental issues in the past, it is important to have good coverage as you age. Unfortunately, some individuals struggle with their teeth their whole lives, despite their best efforts.
Consider getting a check-up and asking your dentist if they foresee any problems in the future that might require special care. For example, receding gums that could eventually require a graft to correct. Having this information will help you choose the right amount of coverage for your future needs.
Consider Your Prefered Practitioners
If you have a preferred dentist, ask them what coverage companies they accept in their practice. This information benefits them as they get to keep a patient and can also help you narrow down the options.
Keep in mind that the coverage they accept might not be right for your budget. If that is the case, you will need to look for new care providers.
Determine Your Coverage Area
When you start looking at plans, consider the overall coverage area. Determine where the coverage extends to and what types of practices fall within that network. This consideration is especially important for retirees who travel south for the winter or plan on making the most of their golden years.
Ideally, you will choose a plan that covers multiple dentists and oral specialists in your area in an emergency.
Determine What Treatment Is Covered
Look at the individual plans and determine what treatments are covered and the percentage of coverage. If you have a history of good oral health, getting discounted, basic supplementary coverage is a viable option. Conversely, if you have poor oral health, you want your bases covered for any surprise treatments.
Evaluate The Costs
Finally, evaluate all of the costs associated with the plan you are evaluating. The monthly premium tends to be the focal point when looking at dental insurance for seniors. However, it would help if you also looked at the coverage versus out-of-pocket fees, the deductible, and the annual coverage cap.
When evaluating the costs, compare them to your dental bills from previous years. It does not make sense to pay more for coverage than you have spent out-of-pocket in the past.
It is also important to evaluate the non-monetary costs when looking at supplementary coverage. Many dental insurance providers will implement a waiting period for costly procedures. Be sure to read reviews from reliable sources when considering a dental plan.
Choosing High-Deductible vs. Low-Deductible
One of the best ways to save on supplemental dental insurance is to adjust to a high-deductible or low-deductible plan based on your coverage needs. High-deductible plans tend to have lower premiums with higher-out-of-pocket costs before coverage kicks in. If you predict that you will only need cleaning or two in the next year, a high-deductible can save you hundreds on premiums.
Conversely, if you think that you will need significant dental care and expensive procedures, it makes sense to have a low-deductible plan with higher monthly premiums. Keep this information in mind when looking at dental insurance coverage.
Using An HSA For Dental Insurance For Seniors
It is important to note that once you become eligible for Medicare, you can no longer add to an HSA. However, you can use an existing HSA to pay your Medicare premiums or cover expensive medical procedures that don't fall under your current coverage. There are exceptions and loopholes based on your employment status, whether you have already enrolled, and if your spouse is still working. You can find more of that information here.
You can convert to an MSA account for Part C coverage. This account offers similar benefits to an HSA with a few more limitations. For example, you cannot use MSA funds for Part D coverage. Your MSA will cover anything your Part C Medicare Advantage plan covers, including dental. Still, it is important to read the fine print and clarify the use of your HSA or MSA when looking at dental plans for seniors.
Start looking at your Medicare options well in advance of the enrolment period. It takes time to do thorough research and get your questions answered. However, that time will save you stress and money down the road.