As we age, looking after our general health matters more, not less. Dental care is usually the part that gets dropped. Medicare does not normally include dental coverage for seniors, and many employers leave dental insurance out of a retirement package, so it is tempting to skip the regular checkups and save the money.
Seniors are at higher risk of dental problems, including tooth loss, gum disease, dry mouth and tooth decay. A number of cognitive and physical conditions cause oral health problems as well. On top of that, neglecting your dental care can make existing health problems worse.
So it is worth having some form of dental coverage in place. There are plenty of affordable dental plans for seniors on the market, and choosing between them is the hard part.
There is no single best plan for a senior, because the right one depends on the state of your teeth, where you live, and which dentist you want to keep seeing. What follows is how to judge any plan against those three things, so you can work out which of the best dental plans for seniors is the best one for you.
Start With the Treatment You Expect
Every plan handles cleanings and checkups well, so comparing plans on preventive care tells you almost nothing. The differences show up on the work that becomes more likely with age.
- Gum disease treatment, including deep cleaning and ongoing periodontal maintenance.
- Crowns and root canals on teeth that have been filled and refilled over the years.
- Extractions.
- Dentures and partials, and the relines and repairs they need later on.
- Bridges and implants.
- Decay at the gum line, which becomes more common as gums recede.
- Treatment for dry mouth, which is a side effect of a great many prescription medicines and speeds up decay.
Write down what your dentist has told you is coming, then check each of those items against the plan. A plan that looks generous on cleanings and vague on dentures is the wrong plan for someone who needs dentures.
Insurance or a Discount Plan
These are two different products and they fail in different ways.
Dental insurance charges a monthly premium and pays a share of the bill, up to a limit each year. The limits tend to be low relative to the cost of major work, and the treatments seniors need most are usually the ones with the longest waiting periods and the smallest share paid.
A discount plan charges a membership fee and pays nothing at all. Instead, network dentists agree to charge members a reduced rate. There is no annual cap, no deductible and no claim to file, but the whole bill is still yours on the day, just at a lower price.
The honest way to choose between them is arithmetic. Take a written quote for the treatment you expect, add the annual cost of each plan to whatever you would still pay out of pocket under it, and compare the totals. On a year of routine care, insurance often wins. On one large piece of restorative work, a discount plan frequently does.
The Two Things That Catch Seniors Out
Waiting periods. Insurance policies commonly make you wait before they will contribute toward major work, and major work is the reason most people over 65 buy a policy in the first place. Ask for the waiting period on each category of treatment, in writing, not just for the plan as a whole.
Annual maximums. This is the ceiling on what the insurer will pay in a plan year. Once it is used up, everything else that year is yours to pay in full. If the work you need costs more than the ceiling, the policy is only ever going to solve part of the problem, and it may be worth asking your dentist whether the treatment can sensibly be staged across two plan years.
Check the Network Before You Look at the Price
If you have used the same dentist for years, they know your history and you trust them, and that is worth protecting.
- Search the network by your own ZIP code, and confirm the practice by calling it. Directories go out of date.
- Check how far the nearest alternative is. Travel gets harder with age, and a cheap plan that puts you an hour away is not cheap.
- Ask whether specialists are in the network, particularly periodontists and oral surgeons, and whether you need a referral.
- Check the plan is sold in your state. Dental products are regulated state by state, and plenty are not available everywhere.
What Medicare Does and Does Not Cover
Original Medicare leaves out most routine dental care, including checkups, cleanings, fillings and dentures. Some Medicare Advantage plans include a dental benefit, but the benefit varies a great deal from plan to plan, and it usually has its own network and its own annual limit.
If you have an Advantage plan, read what its dental benefit actually includes before assuming it removes the need for anything else. Many people find it covers the preventive care and stops well short of the major work.
Questions to Ask Before You Sign
- What will I pay, in dollars, for the specific treatments I know are coming?
- Is there a waiting period on each of them?
- Is there a limit on what the plan pays or discounts in a year?
- Are dentures, relines and repairs included, and is there a limit on how often?
- Is my dentist in the network, and can you confirm that today?
- What is excluded altogether?
- Does a condition I already have affect what the plan will do?
- What does it cost at renewal, and can the price change mid-term?
- How do I cancel, and is there a refund period?
Where People Lose Money
The common mistakes are all avoidable. Buying on the monthly price alone, without checking what the plan does for major work. Assuming “covered” and “discounted” mean the same thing. Trusting an online directory instead of calling the practice. Signing up for a policy in order to have one specific treatment, then discovering the waiting period runs longer than the problem can wait.
Proper dental care matters to your general health, and it matters more with age. Regular checkups and treatment are what keep small problems small, and the right plan is the one that makes the treatment you actually need affordable.
Before you buy, read the fine print and check that the procedures you need, or are likely to need, are included. Ask as many questions as you need to. Knowing the downsides of a plan before you commit is what separates a plan that works for you from one that does not.
