Besides you, guess who has been doing their job for 65 years now. It’s your teeth. And they have to keep on chewing away. They don’t get to go to the tooth HR manager and say, “I retire.” Let’s face facts. At 20 or so chews per each bite taken, after 65 years later it adds to millions of chews.
Medicare does not cover dental, vison or hearing except under rare instances such as breaking your jaw. There’s a reason for this. It’s because if Medicare did cover such things, Medicare would have gone broke years ago. The fact is, it’s common for people to spend more on their dental in a year then they do on their medical.
There are however private insurance options for dental coverage. We deal with around 10 different carriers that have dental plans. These plans fall into two general categories. One category are plans that cover only dental. Many carriers also offer a separate vision plan. The other category is called DVH plans which stands for Dental, Vision and Hearing which bundled all three together.
Dental coverage with plans varies in a number of ways. First is the coverage amount itself which can range from $500 to $10,000 depending on the plan. It’s interesting to know that you may only need to pay an extra $20 to $30 a month to jump from $1,000 a year in coverage to $10,000 in coverage. A second way plans vary is in the copayment amount with some plans requiring a higher contribution from you and others being more generous on their end.
A third key consideration is if you might need dental implants at some point. Implants are expensive and some plans don’t cover implants at all whereas other plans will only cover a small contribution. On the more encompassing end are plans which offer up to $3,000 a year for implants.
A question that is foremost for many people is whether their dentist is in network with a dental plan they are considering. People are often even more loyal to their dentist than they are to keeping their doctor. Most dental plans are PPOs allowing you to go out of network but if you do leave network you will have a higher out-of-pocket cost.
Dental plans negotiate a lower rate with dentists who are in network. These dentists have agreed to accept a discounted amount because of the volume of business these dental plans bring their way. If a dentist is in their network costs for various procedures are often cut in half. All plans will have a dental search where you, or we, can check to see if your dentist is in network.
With a DVH, you can use a portion of your benefit for eye exams and eye glasses or contact lenses.
Speaking of eyes, a common question I often get is whether Medicare, which doesn’t cover vision, covers cataract and other such surgeries. The answer is that when you see an ophthalmologist, who is a medical doctor specializing in the eye, it is covered by Medicare no different than seeing a doctor for your back or your kidneys is. However, laser surgery for vison correction won’t be covered.
A DVH, or a vision plan add on with a dental plan, will give you limited coverage, usually just a few hundred dollars each year in benefits. Likewise, the hearing portion of a DVH will be very limited. Hearing aids can be very expensive and with a DVH plan coverage is usually capped at a $500 contribution for the hearing portion.
Note that there are pre-existing condition limitations on dental plans. You can’t expect to break a tooth needing an expensive crown, and sign up for a dental plan the day after it happens, and expect your new plan to pay for the cost. Plans will have a waiting period. For many plans your benefit percentage also increases when you have been on the plan 2 or 3 years. For instance, you could start out at the plan paying 20% of major dental procedures and then increasing their contribution to 60% after 2 years.
We are experts at dental plans and are happy to send you a quote and answer any questions that you have.
