Medicare Advantage plans now offer basic dental coverage

Once thought of as two totally separate forms of health care, today the insurance industry seems to recognize the connections between dental and medical health.

Senior citizens may not realize it, but Medicare, particularly Medicare Advantage, now provides coverage for dental cleanings.

And those cleanings could save people from what Dr. David Niles calls “horrifically hard-to-fix problems.”

Dr. Niles is one of the dentists at Dental Care at Woodland Crest in Waunakee. Recently, as he and Don Trippie, operations manager for the dental office, realized as they visited the Waunakee Senior Center, most seniors are, in fact, unaware of the Medicare coverage change.

Trippie has worked in insurance for many years. He said prior to 2015, senior citizens were charged a great deal to add dental coverage. But that’s changed.

Even very basic plans have coverage for cleanings,” Trippie said. “The insurance company’s goal is to pay for just the basic cleaning. If they can get rid of infections, you’ll be healthy in the long run.”

Those cleanings can be key to maintaining healthy teeth, according to Niles, who noted that gum recession can occur as a person ages, exposing the root.

Without periodic care and consistent dental hygiene practices at home, with preventive techniques like home fluoride and fluoride treatments professionally, cavities can form on the root and become harder to control, Niles said.

In the past, insurance companies viewed dental and health coverage as two completely separate types of plans. But now the connection between dental health and overall well-being is becoming recognized.

“Now you have a lot more crossover where people acknowledge there’s dental health risks, actually, with people with heart problems. If you don’t control the plaque and bacteria in their months it can affect heart valves,” Niles said.

Medicare Advantage plans, whether through Humana, United Health Care, Blue Cross Blue Shield or others provide the basic preventive coverage, Trippie said. Most dental offices are familiar with the plans, so Trippie advises senior citizens to ask what is covered when they make an appointment with their dentist.

Some plans may also offer some coverage for tooth extractions or replacement, Trippie added.

“Usually it’s a copay, so it may be that 20% is covered by that for a major procedure,” he said.

Dr. Niles hopes to let older adults know about the coverage now in hopes of preventing more complicated health and dental issues in the future.

“It’s a longevity issue, as well, and quality of life,” he said.