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Medicare Advantage Dental Benefits in South Hampton Roads

Are you an adult over age 65 looking for affordable dental benefits in South Hampton Roads? As they leave the workforce, many seniors find themselves without dental coverage since insurance is usually provided through employers. While seniors receive benefits through Medicare, they do not include coverage for important procedures such as dental exams and professional cleanings. Unfortunately, more than two-thirds of seniors have no dental coverage, and this number is expected to grow as 10,000 people turn 65 each day.

Even without dental insurance, dental spending among seniors is on the rise. In fact, in 2016, adults over 65 spent $28 billion on dentistry. Seniors currently are the segment of the population with the fastest spending growth across all demographics. They’re also visiting the dentist more than ever before, with 6 million more seniors seeing a dentist in 2016 than they did in 2006.

Spending may be up, but many seniors are still going without adequate dental coverage. The Kaiser Family Foundation found that among Medicare recipients, over half didn’t receive any dental care in the past 12 months. Another significant finding was that costs were high among those who did see a dentist – 19% spent at least $1,000 on services.

What Choices Do Seniors Have for Dental Insurance?

Seniors over age 65 or those who are permanently disabled are automatically enrolled in Medicare, which is provided by the United States government. Those on Medicare receive red, white, and blue ID cards to present when receiving medical services. Medicare coverage includes many routine medical services, but dental treatment isn’t included. In fact, those with Medicare Part A may only receive dental coverage if a dental exam is required for surgical clearance.

Limits on what Medicare covers often leaves seniors looking for budget-friendly dental benefits in South Hampton Roads. Nearly a quarter of seniors will opt for a Medicare Advantage plan while only a small portion (10%) will purchase a standalone insurance plan.

What Is a Medicare Advantage Plan?

An affordable option for many seniors, Medicare Advantage plans are used to supplement your existing Medicare coverage. These optional plans expand your provider network and also offer price protection in the form of cost-sharing measures, spending limits, and low monthly premiums. With Medicare, medical expenses are reimbursed by the government; however, with an Advantage plan, costs are reimbursed by the private company. Some of the most well-known providers of Medicare supplements include Humana, Aetna, and UHC.

Plan participants receive an ID card much like those given to those with traditional insurance. One key advantage of a Medicare supplement plan is that they often include benefits for vision care, hearing, or prescription medication. Another benefit is that the plans are typically very budget-friendly. Last year, the average cost of an Advantage plan was approximately $420 annually. However, it’s important to note that these plans usually only cover routine dental services, including oral exams and screenings as well as professional cleanings. Those requiring more extensive benefits may wish to consider a standalone insurance plan.

How Do Standalone Dental Insurance Plans Work?

Standalone dental coverage is ideal for those who require more comprehensive care than what a Medicare supplement covers. Like Medicare Advantage plans, standalone insurance is provided by a private company, which reimburses the cost when you visit the dentist. Standalone plans often have several coverage options available, including the three types listed below:


A typical basic plan covers preventive treatment such as dental exams and cleanings, oral cancer screenings, and other diagnostic measures.


Expanded coverage is available with a mid-level plan, including inhalation sedation, orthodontic services, emergency dental care, many types of restorations, and specialized X-ray screenings.


With a premium plan, most dental procedures receive partial or full coverage, from complex restorations to dental surgeries. Premium plans typically cover the following services:

  • Dental surgeries
  • Inlays and onlays
  • Endodontic treatment
  • Complete or partial dentures
  • Periodontal care
  • Crowns and fillings

Many private insurance plans use a 100-80-50 system offering tiered coverage for different services. Under this type of system, routine services are fully covered, basic dentistry is covered at 80%, and more complicated dental work is covered at 50%. Overall, private dental coverage can be less costly than Advantage plans – Bankrate reported that the average cost of standalone coverage was $350 in 2018. However, private plans often don’t include the additional savings on eye care or prescriptions offered by a supplement plan.

Are Dental Discount Plans an Insurance Alternative?

Much like standalone dental insurance, discount plans are provided by private companies; however, it’s important to remember that a discount plan is not insurance. Instead, providers in the dental discount provider’s network agree to accept lower fees for basic services. The savings are then passed on to members, who pay a monthly membership fee and an enrollment fee upon signup. Members receive a card to present at the time of treatment and pay dentists directly instead of filing a claim.

If you’ve been comparing a traditional insurance plan with a discount plan, consider the following benefits of a discount plan:

  • Discount plans have no copays, deductibles, or coinsurance requirements
  • There are no waiting periods before receiving services
  • Discount plan members can switch dentists at any time
  • No limitations on how often you can see a dentist
  • There are no claims to file or paperwork to fill out
  • No exclusions for preexisting conditions or age limits

While standalone insurance may offer more coverage options, discount plans may be ideal for those who will only need routine care. Here are a few examples of services included in discount plans:

  • Dental exams and cleanings
  • X-ray diagnostics
  • Tooth extractions
  • Crowns, fillings, and other basic restorations
  • Root canals

Many people choose discounts through DentRite®, which also provides savings at vision care centers, hearing aid retailers, and pharmacies. If you are in generally good oral health and will only need routine dental services, a discount plan can be a cost-saving option. If you require extensive dental work, however, a standalone plan may be a smarter choice. We’re here to help – give us a call if you have questions.

Are Dental Payment Options a Good Option for Seniors?

Many seniors live on fixed incomes, which can make paying for large dental expenses challenging. Offered by CareCredit and other companies, dental payment options are one way to make dental costs more affordable. These payment options often offer low- or zero-interest, short-term financing as long as the balance is paid in full by the end of the promotional period. Payment options can also be taken out over longer terms – up to 60 months in some cases. If you’re considering a payment option, be aware of these drawbacks:

  • Payment options will require an application and credit check, so not everyone will be accepted
  • Interest rates for payment options can be anywhere from 15-20%, adding to the total treatment cost

Do you have additional questions about Medicare Advantage or private dental benefits in South Hampton Roads? If so, we recommend contacting your local seniors’ organization, the AARP, or our office. We’re here to help you achieve a healthy smile at any age.

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