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Brushing Up on Oral Health

The Dental Care Payment Crunch

What to know about discounts, Medicare and more if you're struggling to pay for dental work

illustration of a tooth and coins on a seesaw, dental costs concept

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For older Americans, the cost of visiting the dentist can be a shock. After years of having dental coverage through employer-sponsored insurance plans, people age 65 and older are often surprised to learn upon retirement that Medicare does not pay for most dental work.

Congress is currently debating whether to add dental coverage to Medicare as part of a $3.5 trillion social spending package, and AARP supports the effort. For now, however, older adults are mostly on their own when it comes to paying for dental care, and surveys show that many skip going to the dentist because of the cost. Here are some ways to get dental care when you’re on a budget.

Pick the right Medicare Advantage plan

While original Medicare and Medigap plans do not pay for most dental work, many Medicare Advantage plans offer some type of dental coverage. Benefits vary, but many plans pay for preventative care such as oral exams, cleanings and x-rays, and some cover a portion of the cost of expensive procedures such as crowns, bridges and root canals.

Share your financial constraints

If your dentist recommends a particularly expensive treatment, have a conversation with him or her about the financial challenges you face. “It is always a good idea to talk to your dentist about anything that might be a barrier,” says American Dental Association spokeswoman Ruchi Sahota, a dentist in Freemont, California. “If we know what the barriers are, then we can potentially find solutions together.” 

Your dentist may suggest a less expensive treatment or a way to delay a procedure until you can pay for it. Most dentists these days are also willing to set up payment plans. In addition, some dentists will reduce your bill by 10 or 15 percent if you offer to pay by check upfront, says Michael Reed, a clinical dentist in Dallas and a principal for Mobile Dental Care.

Visit a dental school clinic

Dental students, supervised by a licensed dentist, get hands-on experience, and you save 20 to 70 percent off most procedures. Search for a program in your area on the American Dental Association website.

See a dental hygienist

At least 42 states now allow dental hygienists to treat patients without the specific authorization or presence of a dentist. In many states, you can have a hygienist do your cleaning, exam, X-rays, sealant or fluoride treatment, and the cost savings can be significant. 

Use free or low-cost dental providers 

Some nonprofits and government-funded health clinics provide free or reduced-cost dental services (often based on income). Their services are in high demand, so expect a wait. Many dentists also offer one or two days a month of free or low-cost care. Your local health department or United Way can connect you to programs in your area.

Investigate stand-alone dental plans 

If your Medicare or private health plan doesn’t have dental benefits, you can shop for a stand-alone dental plan. Compare prices and coverage in the government’s health insurance marketplace at healthcare.gov

Sign up for a dental savings plan 

These noninsurance dental plans negotiate discounts ranging from 10 to 60 percent on dental costs. You pay a small monthly fee to join, and you get the discounts as long as you use a dentist that accepts the plan. Search for plans in your area at DentalPlans.com


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Join a dentist’s membership plan

A growing number of dental offices are offering their own in-office dental plans for patients that do not otherwise have dental benefits, Sahota says. Here’s how the plans typically work: you agree to make a regular monthly payment to be part of the plan. In return, you receive preventive care at no charge and other procedures at a significant discount. “This type of dental program has recently been gaining popularity and has been successful for patients who are looking for alternative affordable dental plans,” Sahota explains.

Shop around

Prices for dental services can vary by hundreds of dollars, even in the same community. Look up average prices in your area at FAIR Health, a national nonprofit dedicated to bringing transparency to health costs, and then call a few dentists for quotes. If you live in a community with a high cost of living, driving to a less expensive area can boost your savings.  

Practice prevention

Taking care of your teeth daily — and yes, seeing a dentist on a regular basis — is the most cost-effective way to reduce your dental care costs. “Prevention is priceless,” Sahota says. “Brushing twice a day with a fluoride toothpaste, cleaning in between your teeth, maintaining a healthy diet and visiting your dentist can help keep your body healthy and keep dental costs down.”