It’s hard to believe that with such vast improvements to dental technology, that over 36 million Americans have no teeth at all, and over 120 million have at least one missing tooth. Additionally, with so much time spent on screens and phones, it’s predicted that over half of the planet will need glasses by the year 2050.
So why is it that Medicare doesn’t cover Dental or Vision?
For those of us in the senior space, oral health and vision are essential to a holistic and positive healthcare plan. Let’s sit down today, and discuss what we’re missing with Medicare, the potential consequences of these gaps and how you can protect your health and your wallet from poor healthcare options.
First let’s get a basic understanding of Medicare and it’s goals. The system was put in place initially to keep America’s elderly population healthy and to give them a more lucrative retirement. For some Americans, the transition onto Medicare can be a huge weight lifted from their shoulders, for others, it can seem like a step in the wrong direction. Gaps, co-insurance and third party insurers make the medicare system a mess that at best is confusing, and at worst bankrupts it’s recipients.
One fundamental flaw in Medicare is the Dental and Vision gap. While the Medicare website is quick to mention their eyeglass coverage for people who have had cataract surgery, there is absolutely no other coverage for Dental or Vision included in Medicare. We’ve all heard the saying, “an ounce of prevention beats a pound of cure.” With our oral and ocular health, it is no different. Preventative care is always a better option than responsive care.
So what health outcomes can we expect with a lack of Oral and Ocular care?
We’re all aware of the consequences of poor oral hygiene. Gum disease, tooth loss and simple bad breath are some obvious reasons to keep a clean mouth, but oral health plays an even larger role in our overall health. According to the Mayo Clinic, poor oral hygiene has been linked to things like Endocarditis, Cardiovascular Disease, and even Pneumonia. The health of your teeth can also be a sign of other underlying health issues. Diabetes, Osteoporosis and Alzheimer's have all been linked to poor oral health.
Vision loss is another major area of concern for overall health and wellbeing. According to one study, a lack of proper glasses can lead to restrictions in mobility, independence and educational achievement. Poor vision can also lead to falls, injuries, and mental health problems related to social isolation.
It’s not a small issue to take care of your eyes and teeth, but it’s also no small expense. A typical dentist visit can run almost $300 and an eye exam up to $150. Not counting the cost of scheduled and emergency procedures, that is $750 annually for preventative care alone.
While Medicare and most group plans fail to provide dental coverage, there are a range of products available in the insurance marketplace to cover this gap. A typical Dental/Vision plan provides coverage based on a 100/80/50 system. That means that 100% of preventative care costs, 80% of typical procedure costs and 50% of advanced or atypical procedures are covered by insurance after the deductible is met. For most people, a policy will cost less than $50 per month for dental and vision coverage, reducing their yearly preventable care costs by over $200. In the case of more serious procedures, these savings can be 5, 10 or even 20 times that much.
So which insurer do you choose, and which type of coverage?
Here at Strong Family, we offer a variety of products from multiple insurers. With Dental/Vision, we always recommend using an indemnity policy. This means that the insurer pays for the real cost of care, and can be used with any dentist without the hassle of networks. These indemnity policies can either reimburse the customer for the costs of their dental and vision care, or can send money directly to the doctor’s office.
One trick that we recommend to the financially savvy is to actually pay for the doctor’s bill with a credit card, earn the rewards points, miles, or cash back, then pay down the credit card balance with the insurance pay-out.
While we all have our favorite companies, we always recommend getting a holistic picture of your financial and insurance needs before deciding which products to purchase.