Are These Plans Worth it?

Dental disease doesn’t only affect your teeth. Tooth loss and dentures can affect your nutrition intake, limiting the types of foods you’re comfortable eating. Gum disease can also increase your risk of stroke, heart attack and diabetes, and it is also linked with dementia. Plus, dentists play an important role in the early detection of oral cancer. Proper dental care plays a huge role in your overall health, and your dental needs will only increase with age.

High Cost is a Barrier to Dental Care

Seniors — or retirement-age adults — often lose their employer-provided dental insurance at a time when their dental needs and costs are increasing. Consider these statistics from the Centers for Disease Control and Prevention (CDC):

• About two out of three adults 65 and older have gum disease.
• One in five adults 65 and older have untreated tooth decay.
• One in five adults aged 65 and older have lost all of their teeth.

At the same time, more than half of seniors (53%) say they’ve had to delay dental care due to the high cost, and 23% of Medicare enrollees say they’ve delayed or gone without dental care, according to statistics from the Kaiser Family Foundation.

Overall, the need for senior dental care is clear, but what about dental insurance?

Dental insurance can be a valuable tool to protect you from the high cost of dental care. Like any insurance, deciding whether it’s worth the cost or not depends on your specific needs.

If you only need twice yearly cleanings and X-rays, you’d probably spend more on an insurance premium than you would if you paid out of pocket. But most seniors are likely to need more care than that, making dental insurance a viable way to help offset those costs. For example, 19% of Medicare beneficiaries spend over $1,000 a year on dental care (for those that actually receive care at all).

Does Medicare Cover Dental Work?

No. However, there are some exceptions:

• X-rays related to treating a fractured jaw or facial bone
• Removal of teeth to prepare the jaw for radiation treatment of a tumor
• An oral or dental exam — performed on an inpatient basis — as part of a work-up before kidney transplant surgery or heart valve replacement
• Dental care that is integral to another Medicare-covered procedure, e.g., wiring teeth when treating a jaw fracture

So, if you have Original Medicare (Parts A and B), most regular dental care will not be covered. However, if you have a Medicare Advantage plan (Part C), there’s a good chance that your plan includes dental benefits. As of 2020, 88% of Medicare Advantage plans offer some type of dental coverage, according to the Kaiser Family Foundation.