When you first sign up for Medicare coverage, it’s only natural to have a lot of questions. After all, this transition can be turbulent, whether you’re signing up for Medicare because you’ve reached the age of retirement or you need to sign up for disability. Amidst the chaos in adopting a new insurance plan, understanding your dental coverage is one of the most common issues among new Medicare subscribers.
It’s not uncommon for many seniors to suffer from orofacial pain as they get older. This risk is heightened if the Medicare member is a smoker or partakes in other behavior that is deemed risky by your dentist. But even if they get the proper orofacial pain diagnosis, from an accredited dentist, there’s no guarantee that your future dental surgeries or subsequent treatment are covered under your Medicare plan.
Here are the top five ways that Medicare members are getting the dental coverage they need:
1. Sign up for a Medicare plan with dental
Most basic Medicare plans do not include dental procedures in their insurance policies. In many of these basic plans, dental procedures are only covered if a dental issue occurs in the hospital. Anything outside of that realm means that you will have to pay for the cost by yourself, payments that can add up quickly. However, some of the “advantage” plans offered by Medicare are attempting to bridge this gap. With the Part C Medicare coverage plan, basic preventative dental procedures are included, like cleanings and X-rays. In some cases, these plans might also include coverage for extractions or fillings.
While these basic plans might seem fine for now, you have to think about the future of your oral health. For example, if you’re a smoker, you might want to consider the possibility of future surgeries or pain-relieving medications. In the event that you’ll eventually need dentures or more serious oral procedures, you will need to look for other Medicare options.
Luckily, there are other options to consider when you’re on a Medicare plan.
2. Invest in PACE
PACE is one of many Medicare supplement plans that strive to fill in the gaps left by its lack of dental coverage. With PACE, which stands for “Programs of All-Inclusive Care for the Elderly,” members are connected with local health providers for a range of services. These might include dental services, adult day care programs, and physical therapy programs.
Unfortunately, this option is only available for Medicare subscribers who are over the age of 55. You also need to live within a designated PACE service area and need nursing home-level care. If you’re simply looking for dental coverage as a young person with a disability or as a healthy older person, you should look into other insurance company options or coinsurance programs.
3. Consider investing in Medigap
Medigap, like the name implies, helps you cover any gaps in your current Medicare insurance plan. instead of paying out of pocket expenses, Medigap helps cover deductibles and other similar insurance payments. Unfortunately, this type of Medigap Supplement is not beneficial for those looking for help covering routine check-ups and minor dental health complications. If you invest in Medigap, this only covers emergency situations, like oral surgeries as a result of another injury.
4. Talk to your preferred dental provider
Just because you have Medicare doesn’t mean that you have to get dental insurance through this insurance policy. Many dental professionals offer dental discount cards to help supplement the cost of care. At the very least, your dentist might be able to recommend a discount dental plan with a local provider so you can get the dental health care you deserve.
5. Rely on your spouse’s coverage
Of course, this isn’t an option for everyone, especially if your spouse is also on Medicare. However, Medicare members with spouses on separate insurance plans can still be covered for dental services under their partners. Just be sure to check your eligibility before making sudden decisions.
Understanding insurance is hard enough without subscribing to a new plan. When you need dental health coverage, consider these options before you take the next step.