The policy regarding Medicaid payment for dentures varies according to the state. Some states have no coverage for dentures at all. Other states have a yearly cap on the amount Medicaid will pay.
Limited coverage is applicable in some states, and only one set of dentures will be covered for a specific time frame, such as every five, or ten years. There are exceptions in certain states if the dentures are required due to a disease, or a trauma. The Medicaid payment for partial dentures is generally based on the number of teeth the individual has, and if there are not enough teeth left to make chewing plausible. Medicaid will not pay for new dentures in most states if the existing dentures can be relined for a proper fit, or repaired. For states with Medicaid coverage regarding dentures, prior approval is required for new, or replacement dentures. The individual must prove the dentures are appropriate and necessary.
Alternate Dental Coverage for Seniors
When an individual requires dentures and Medicaid will not cover the cost in their state, there are options. There are facilities who offer dentures at a much lower cost, or free in some cases to individuals with an income below a specific amount. Payment options are often offered to individuals who do not qualify to receive their dentures for free. There are also insurance plans designed for seniors with specific coverage for full, or partial dentures. Some of these plans are costly, while others are designed for low-income individuals. These plans sometimes have a period where certain services are not available. For instance, one plan may require an individual to have the coverage for six months before dentures are covered, another may offer immediate coverage, and yet another may cause the individual to have to wait a year.
Costs of Alternate Denture Coverage
These plans additionally have deductibles. This may be a yearly amount, and once this amount is met any services used for the remainder of the year are covered. This can be a specific amount for each service rendered, or a percentage of each service, payable at the time of service. Medicaid can usually offer advice to recipients as to the best place to go for dentures, the most affordable prices, and the most popular, and acceptable insurance plans. Sometimes the direct manufacturer of dentures will offer their services free for low-income individuals in need of dentures. In this case, the individual would be required to pay fees to the dentist, but not pay for the actual dentures. These programs are not generally advertised, and the individual must contact the manufacturer directly.
Specific Options for Seniors Requiring Dentures
The first place for an individual to begin is with Medicaid. Many states do offer full, or partial coverage for seniors on Medicaid with a low income. The best way to do this is to contact or visit a local Medicaid office. Most states have either free clinics or reduced-cost dental clinics. These clinics can be easily located online, and the individual must compare the pricing, and services available according to their income bracket.
Hospitals With Clinics
Some local hospitals have dental clinics available. The individual should call the hospitals to ascertain what services are offered, if there are payment plans, the cost of the fees, and if fee reductions are available for low incomes. FQHC is an abbreviation for a Federally Qualified Health Center, and they are also referred to as Primary Health Care Service Delivery Sites. These facilities sometimes have dental care available and are usually located in underserved areas. Any individual currently receiving Medicaid automatically qualifies for services at one of these facilities. They offer dental, and denture services sometimes covered by Medicaid, and other services not covered by Medicaid at a discounted rate.
Community Health Centers
Community Health Centers have locations throughout the country and provide reduced-cost and free health services. This includes dental care, and dentures. These facilities receive their funding from the HRSA, or Health Resources and Services Administration. Some dentists donate their services through a Donated Dental Service Program. For individuals with a low income, these dental services are free. Dental Schools are another alternative and provide low-cost, and quality dentures, and dental care. The work is performed by dental students, under the supervision of a licensed dentist with experience.
PACE Program for Seniors
PACE stands for Program of All-Inclusive Care for the Elderly. This program operates in some states and is available for individuals on Medicaid with their level of care classified as a nursing home. The last option is private health. Some of these plans offer dental coverage for dentures, with the amount covered varying from plan to plan. The specifics of the plan must be checked including, what is covered, the amount of coverage, the amount of the premium, any discounts available for seniors, and any limitations on coverage.
Reducing Denture Costs
You can find many places that offer free dentures to seniors. Starting from Medicaid denture coverage for seniors to charity programs that offer low-cost or free dentures, you can get an option that fits your budget. In your reducing denture costs endeavor, you should consider striking a balance between affordability and quality. In dental care, “low-cost” does not always translate to “low-quality”.
The first place that comes to mind when thinking about places to get free or low-cost dentures is dental schools. They can be facilitated by a dental student. If you are concerned about a student handling your teeth, keep in mind the fact that every student is supervised by a certified dental practitioner. However, the visit may take longer than it is supposed to last because there will be teaching stops while your teeth are being worked on. That should not be a big deal given that students are more careful because they are graded on their work. If that seems like an option you can go with, visit a nearby dental school and get the dental care you need at a pocket-friendly price.
The US government offers various medical coverage services such as Medicaid denture coverage for seniors in an effort towards reducing denture costs. Sometimes, Medicaid does not cover denture costs and if it does, it may not cover all the costs. Nevertheless, you should check with your state’s Medicaid program and find out if they can help you pay for your dentures. Community health centers also can help you cut down on the total cost of dentures. Check the ones that get funding from the Health Resources and Services Administration (HRSA) as well as Federally Qualified Centers (FQHCs). Additionally, the Health and Human Services department of the United States run denture programs for the poor. You can take advantage of the programs such as United Way to get free dentures.
You may want to check charity organizations that offer free dentures and dental care to low-income households. There are many such organizations. Therefore, apply for the programs and you can get one that can take care of your dental care needs at a significantly cheaper cost as compared to your dentist.
Dental Lifeline Network
This program offers free dental care services to individuals who cannot afford care such as seniors and the disabled. You can find out if you are legible for the program.
Coverage Of Dentures By Medicare Part C
This program enables you to get the benefits you would have gotten from the Original Medicare. It is an alternative to Original Medicare. The Medicare Advantage plan is offered by several insurance companies that are approved by Medicare. The insurance companies are usually required to offer almost the same level of coverage as Original Medicare. However, many plans offer coverage more than the original Medical to include dentures and dental care services. Therefore, it is important to check the Medicare Advantage plan you’re considering whether it is offering the specific coverage you’re looking for.
Comparison Of Dental Insurance And Dental Discount Plan
Usually, it can cost you between $200 and $500 yearly for an individual plan. With the plan, you can get comprehensive coverage. However, most insurance companies don’t cover all dental procedures and services. For instance, many insurance companies regard dentures as well as dental implants as “cosmetic”. it is rare to find an insurance company that can offer a coverage inclusive of dentures in a single package. Even Medicaid denture coverage for seniors rarely offer a full coverage package inclusive of dentures. Therefore, dental insurance is not suitable for everybody. On the other hand, dental discount plans cover a wide range of dental care services. For as low as $97 annual fee, you get coverage for dentures and dental implants. You can get a maximum discount even if you have a pre-existing condition. In this plan, there is so much hassle, you just get to a dentist, show him a membership card and you are able to cut down on costs up to 60% on almost all procedures including dentures.
Why Do Seniors Prefer Dentures?
Elderly people are more likely to lose teeth and therefore, dentures give them a replacement option. Over time, there has been a variety of types of replacement teeth. The modern ones are more comfortable as well as have a fantastic appearance. The following are some of the reasons why seniors prefer dentures over modern cosmetic dentistry solutions.
Benefits Of Dentures
The dentists can make the replacement look good and fit perfectly. Today, it is hard to recognize replacement teeth when a person wears them. Additionally, apart from dentures being comfortable, they are also easily fixable, unlike many other modern cosmetic dentistry solutions. There are a variety of replacement teeth available. Partial dentures see to it that one or more teeth are replaced to fit perfectly with the others. Moreover, they are easily removable for cleaning and therefore, easy to care for. Dentures are a suitable option for seniors because they can be affordable. Losing teeth, being a natural part of life, should not hinder the elderly from enjoying their lives.
Senior Health Insight is a free online resource for helping both seniors and caring families gain an understanding of the various healthcare solutions available to cater to a variety of circumstances. Senior Health Insight was created by health and insurance professionals to provide a one-stop information source for senior health care. Let Senior Health Insight help you and your family navigate Senior Health complexities with confidence.