Try one of these options to get low-cost dental care.
Rachel Christian • July 26, 2022 • Advertising Disclosure
Editor's Note: This story originally appeared on The Penny Hoarder.
Affording dental work can be tough if you’re an older American on Medicare.
That’s because Original Medicare — which covers a majority of beneficiaries — doesn’t include coverage of routine dental care.
Congress is considering whether to add dental coverage to Medicare as part of a $3.5 trillion social spending package — but progress has been slow.
For now, older adults are mostly on the hook when it comes to paying for their own oral health care.
Here are seven ways to get free or reduced dental care. We’ll also explain what limited dental benefits Medicare coverage provides, along with other options like private insurers and Medicaid.
Medicare beneficiaries who use dental services spent an average of $874 a year out-of-pocket in 2018, according to an analysis by the Kaiser Family Foundation.
That’s a lot of money, especially if you’re on a fixed income.
Here are a few tips and tricks to save big on oral health.
This program by the American Dental Association offers free, comprehensive dental treatment to specific groups, including people ages 65 and older.
You can use this tool on the Dental Lifeline Network website to learn about the specific program details in your state.
Heads up: Due to long wait lists, several states and counties are no longer accepting new applications for the Dental Lifeline Network program. When we did a quick search, states like Texas, California and Kentucky weren’t accepting new applications.
Federally funded community health clinics provide reduced-cost or free dental care services to people with low incomes.
Many operate on a sliding scale system while others offer flexible payment plans.
Wait lists can be long, so it’s important to reach out to your local clinic early.
Follow this link to find the nearest community health clinic near you.
Some dental schools offer low-cost cleanings and other routine care to members of the community.
Most of these teaching facilities have clinics that give dentists-in-training an opportunity to practice their skills while providing care at a reduced cost.
You can search for a program in your area by visiting the American Dental Association website.
There’s no guarantee that a dental program in your area currently offers free or reduced dental care. You’ll need to contact each program individually to see what’s available.
When you call, make sure to ask about any fees up front.
This website offers a comprehensive list of dental offices with sliding scale payment options, community health center locations and dental school clinics.
It does a great job of breaking down requirements and eligibility (if any) for services in your area, and provides contact information for each service.
Just enter your ZIP code into this search tool to get started.
It might be difficult to ask for help, but being honest with your dentist about your financial situation can help.
Your dentist may be able to offer a less expensive treatment, help you set up a payment plan or provide a sliding scale payment option.
Ask if you can receive a discount for referring a friend. Or, see if it’s possible to knock off a few bucks in exchange for a positive online review of the dentist office.
Dental savings plans aren’t dental insurance, but they may still be able to save you money.
Here’s how it works.
With a dental savings plan, you pay an annual fee, then get a 10% to 60% discount on most dental services such as exams, cleanings, fillings, root canals and crowns.
The plan contracts with dentists who agree to reduce their fees, then you pay the participating dentist directly using your discount.
You’ll still pay out of pocket for those services, but the idea is that you won’t pay as much as you would without the plan.
But let’s be clear: Dental discount plans aren’t free. The average cost for plans in Orlando, Florida, for example, ranged between $135 to $170 a year.
You can visit DentalPlans.com to find a plan in your area.
Dentists can charge widely different prices for the same exact procedure.
When you’re paying out of pocket, it pays to shop around.
You can find average prices in your area by using FAIR Health Consumer, a national nonprofit organization. The site lets you search by specific procedures, so you get the average cost for a root canal or teeth cleanings in your area.
Armed with knowledge, call around to different dentist offices for quotes. Ask about senior discounts.
You can also look for discounted dental care on sites like Groupon.
A quick search on Groupon for dental services in Houston, Texas, showed numerous X-ray, exam and cleaning packages for $25 to $50. One office even offered $700 toward dental implants for just $40!
If you live in a high-cost-of-living area, driving to a less expensive area is another smart way to save money.
Original Medicare doesn’t provide coverage for routine dental, vision or hearing benefits.
Original Medicare will only cover dental work if it’s deemed medically necessary, i.e., if you were hospitalized after a traumatic injury that also affected your jaw, teeth or mouth.
Here are the other dental services covered by Medicare Part B:
So if you’re looking for standard dental care like teeth cleaning, X-rays, fillings, extractions, dentures and more — the cost comes out of your pocket.
Medicare Advantage plans are administered by private insurance companies. They must provide the same basic coverage as Original Medicare, but plans may offer additional benefits, such as dental.
About 94% of private Medicare Advantage plans provide some dental coverage, but the amount of coverage varies by plan.
According to the Kaiser Family Foundation, nearly all Medicare Advantage plans that include dental offer coverage for oral exams, cleanings and X-rays.
But benefits for more advanced dental work such as root canals, implants and dentures can carry substantial copays, depending on the plan.
Medicare Advantage plans almost always impose restrictions, including annual dollar caps and how often you can get certain benefits, such as dental implants.
The average annual limit on dental benefits among Medicare Advantage plans that offer more extensive benefits was about $1,300 in 2021, according to KFF.
If you’re in a Medicare Advantage plan, it’s important to check the plan’s summary of benefits or evidence of coverage to see exactly what dental work is covered. It can vary widely from plan to plan.
About half of all Medicare beneficiaries — 47% — did not have any form of dental coverage in 2019, according to the Kaiser Family Foundation.
Besides Medicare Advantage plans, other sources of dental coverage for seniors include Medicaid and private plans, such as employer-sponsored retiree plans and individually purchased dental plans.
A standalone dental policy for people 65 and older is typically $20 to $50 a month, according to AARP. These dental insurance policies usually come with an annual deductible of $50 to $100.
Dental insurance plans usually cover checkups and cleanings 100% but you will probably owe 20% to 50% for other services, such as tooth extractions or dentures.
The devil is in the details with private dental plans: It’s important to shop around and carefully compare benefits to make sure you’re getting the best deal.
Here are a few other things to keep in mind about private dental insurance plans:
About 1 in 5 Medicare beneficiaries is also enrolled in Medicaid, sometimes referred to as being “dual enrolled.”
Medicare usually pays as your primary insurance when you’re dual enrolled. But if you need dental work done or even a yearly cleaning, consulting your Medicaid handbook is a smart move.
If you meet Medicaid low-income requirements in your state, you may be able to receive free or low-cost dental care for certain procedures and services.
But it’s not a guarantee. While most states provide at least some emergency dental services, only 36 states and Washington, D.C., offer limited or comprehensive dental benefits for adults, according to the National Academy of State Health Policy (NASHP).
Even if your state Medicaid program includes dental, it may not pay out much. Of the 36 states with routine dental care coverage, only 23 states offer an annual expenditure cap of $1,000 or more.
Adult Medicaid recipients in Arkansas, for example, only receive up to $500 in dental services a year. So if you need a $3,000 root canal and you’re dual enrolled with Original Medicare, you can expect to pay $2,500 out of pocket in that state.
According to Medicaid’s national website, “States have flexibility to determine what dental benefits are provided … There are no minimum requirements for adult dental coverage.”
To find the Medicaid office contact information for your state, click here.
Disclosure: The information you read here is always objective. However, we sometimes receive compensation when you click links within our stories.
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