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Minding the Gap


Protect yourself from costly dental coverage gaps by beefing up your Medicare with a supplemental insurance program.

Medicare is adequate as far as general insurance goes, but its coverage is limited or even missing in many areas of treatment – especially when it comes to dental treatment.

If you have regular Medicare, only certain emergency procedures (such as treating knocked-out or broken teeth and extractions) are covered as part of a hospital visit. Everything else, you pay for out of pocket. With a routine visit for exam, x-rays and cleaning averaging almost $300, these costs add up fast.

Smart consumers like you are taking Medicare’s coverage issues into consideration in preparing for retirement. By carrying supplemental dental insurance, retirees can make certain they get the care they need and aren’t left paying more than they can afford in surprise medical expenses. How can you take advantage of these programs?

Beyond Advantage Dental: Filling the Cavities in Medicare Coverage

The scope of what Advantage will cover as far as dental procedures varies depending on what plan you have, but all of them are lean at best. For example, you could get at least 80% of that $300 dental visit bill paid for, and basic treatment such as extractions or root canals partly paid for as well. But if you have a chipped tooth that requires a veneer or you want more than the most basic amalgam for your fillings, you’ll likely pay for that yourself. Extras that aren’t really necessary, such as nitrous for nervous patients and children, likely won’t be covered either.

Fortunately, you can use supplemental dental insurance to close these gaps and protect yourself and your retirement savings. These policies cover what Medicare and even Medicare Advantage won’t when it comes to caring for your mouth. If you anticipate needing more than that—and most of us do, especially as we age—consider investing in one of these policies.

Depending on the type of dental insurance you get, coverage can vary, as can your copayment and deductible. It would be smart to check with us to help sort out which balance of low cost and coverage is right for you. On average, an individual dental care policy costs around $450 a year. Depending on the deductible and out-of-pocket costs, that could pay for itself in as little as a yearly check-up and two routine cleanings a year.

Weigh Your Options

You might still wonder whether paying premiums for dental insurance is actually worth it. If so, consider the financial impact of two things: regular dental work paid for out of pocket, and all the extra dental work you could end up paying for if you have to put off getting work done due to lack of money–like 60% of Americans yearly.

That $300 routine visit could discover one or more cavities, which cost between $100 – $4,000 each depending on severity and filling type to deal with. Left untended, these cavities may lead to root canals (up to $1,000 for treatment and crown) or extractions (up to $600 and your tooth). If the jawbone becomes involved, prices go up beyond that.

Do you have that kind of money tucked away in case of emergencies? Most of us do not. Whether you are already retired or looking into your options as you prepare, it pays to consider a dental supplement to your Medicare insurance.

Wiley Long is founder and president of Medigap Advisors, and is passionate about helping people navigate the confusing waters of Medicare. He is the author of The Medicare Playbook: Designing Your Successful Health Coverage Strategy, a clear and simple explanation so you can make the most of your Medicare coverage. For more information visit www.MediGapAdvisors.com.

 

 
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