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With age, dental care and oral health become increasingly more important. According to the Center for Disease control and prevention (CDC) - about 2 in 3 adults aged 65 or older have gum disease. 1 in 5 adults over 65 have untreated tooth decay.
You might not know that oral health conditions like gum disease are linked to major health issues like diabetes, heart disease, and Alzheimer’s. This means that maintaining a healthy smile is part of living a happy and healthy life.
Many older Americans are missing out on dental coverage because not all Medicare and Medigap programs cover dental. To ensure you have access to the dental coverage you need, a supplemental dental insurance plan can provide those critical dental benefits that your Medicare or health insurance plans may not cover. If you find yourself without dental coverage, consider one of our Delta Dental plans that may be appropriate for seniors .
Waiting periods refer to a period of time before your full dental benefits kick in. During this time, your dental plan may not cover certain procedures. Depending on the plan you choose, the waiting period could range from a month to a full year. If you're switching dental insurance providers, your new provider may waive the waiting period with proof that you didn’t previously have a break in coverage, usually no more than 63 days.
Medicare is a federal program run by a branch of the U.S. Department of Health & Human Services. It is available to most people aged 65 or older, younger people with disabilities, and people with End Stage Renal Disease. There are several variations of Medicare coverage including Original Medicare, Medicare Advantage, and Medicare Supplemental Insurance (Medigap).
Original Medicare “Pays providers the Medicare-approved rates for covered services per Medicare rules and regulations” and “covers medically-necessary and outpatient health care.”i It does NOT cover services like routine vision, hearing or dental care.
Medicare Advantage consists of hospital insurance and medical insurance plus usually a Medicare Drug plan. Note that Medicare Advantage “may offer some extra benefits like vision, hearing, and dental services.”ii However, these plans may still only offer limited coverage for certain benefits.
Medigap is “Medicare Supplement Insurance that helps fill ‘gaps’ in Original Medicare and is sold by private companies.”iii They typically do NOT cover vision or dental services.
Wondering if you qualify for Medicare? Check your eligibility using Medicare’s Online Eligibility and Premium Calculator.
Medicare Basics: https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/how-does-medicare-work
Medicare and Oral Health (Kaiser Family Foundation): https://www.kff.org/medicare/issue-brief/drilling-down-on-dental-coverage-and-costs-for-medicare-beneficiaries/
Oral Health Resources for Seniors: SeniorsOralHealth.org.
Additional content from Delta Dental of Washington:
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Is dental insurance worth it?
Dental Terms Demystified: annual maximum, deductible, copays, coinsurance