Seniors face distinct disadvantages when it comes to covering the cost of dental care:
- Seniors typically have a fixed income, and so money can be tight.
- Traditional Medicare usually doesn’t cover dental care.
- Retirees typically don’t have employer-sponsored dental insurance to help with their dental bills.
These out-of-pocket dental care bills can be a shock to new retirees. Two-thirds of seniors do not have dental coverage, a study by the Kaiser Family Foundation finds.
The Centers for Medicare & Medicaid Services is currently considering a proposal to make dental benefits available to Medicare beneficiaries “under certain conditions deemed medically necessary,” but it remains to be seen how many people this will help.
For now, at least, the tooth fairy isn’t coming. Seniors are on their own to maintain oral health on a budget. Here are our best tips for limiting the expense of dental care in retirement.
1. Check into Medicare Advantage
Medicare Advantage (Part C) is the private insurance alternative to traditional Medicare (also called Original Medicare).
These plans often cover costs that Medicare doesn’t pay, including offering preventive dental benefits, such as teeth cleaning.
Seniors who skip dental care to save money are inviting trouble. Untreated dental problems are linked to serious medical problems, including heart disease.
Switching to a Medicare Advantage plan to save money on dental care isn’t an automatic no-brainer, though.
- Medicare Advantage plans vary widely in their coverage and costs.
- If you switch to Medicare Advantage from Original Medicare with a supplemental (Medigap) plan, you could lose supplemental coverage if try to switch back.
- When all is considered, seniors have reported more satisfaction with Original Medicare than with Medicare Advantage plans.
We drill into the pros and cons of each in “Seniors Rate This Type of Medicare Higher for Satisfaction.”
2. Use a health savings account (HSA)
You can save money by paying your dentist bills with money from a health savings account.
If you qualify for one, HSAs let you contribute a set amount of money annually for spending tax-free on eligible medical (including dental) expenses.
HSA contribution limits in 2022 are $3,650 for individuals and $7,300 for a family.
Learn more about the value of these tax-free accounts: “IRS Increases Limits for This Tax-Free Account for 2023.”
One important note, however: Once you enroll in Medicare, you no longer can contribute new funds to an HSA. You can still use any existing funds in your account to pay for dental services, however.
3. Consider alternatives to dental insurance
There are numerous ways besides insurance to cover the cost of dental care.
Did you know, for instance, that university dental schools often give free or reduced costs for dental work? Or that charitable clinics where you live may offer dental care at a reduced cost?
Dental tourism — traveling to another country where dental care standards are high and costs are less — is another approach that many have used.
For more ideas, read “10 Alternatives to Dental Insurance.”
4. Consult with your dentist
When considering how to cope with the cost of dental care, your first move should be to schedule a dental exam. At the appointment, talk to both your dentist and the dentist’s bookkeeper.
The dentist can recommend a plan for your treatment. Ask the dentist to tell you which procedures should be done immediately and which can wait a bit. This way, you can map out your costs over the next year or two or longer, and budget to meet the costs.
Next, talk with the dentist’s bookkeeper. Say frankly that you have a tight budget for dental care and you would like help spreading out the costs. The dentist may allow you to pay for a costly procedure in, say, two or more installments. Or have the most urgent procedure done this year and wait for next year to do something that can wait a bit.
5. Buy dental insurance — or not
Is dental insurance cost-effective? Saying “it depends” isn’t just a way to weasel out of making a tough decision.
The plan you purchase, the cost of the services and the work you’ll need done all determine the value of insurance for you.
If your teeth and gums are healthy and your dentist says that no expensive procedures will be required in the near future, paying dental bills entirely out-of-pocket can make sense.
Here’s how to know: Look at your expected costs for the next year with and without insurance. Next, talk with your dentist’s bookkeeper — he or she bills insurance and sees each plan’s coverage limits. Ask if insurance seems worth buying, given the procedures recommended and, if so, which insurers offer better coverage.
6. Get the cash discount
Some dentists will discount the cost of their services by a specific amount — 10% is common — if you pay your bill in cash at the time of the visit.
Ask your dentist’s receptionist or bookkeeper to find out if the discount is available.
7. Phone around for the best rates
When you are considering an expensive dental procedure, do what you would do if you were buying a washing machine or having the house painted: Phone around.
Call other local dentists to find out costs and compare.
Also, CostHelper Health collects and publishes data on consumer costs, which can give you an idea of prices.
8. Hang onto your workplace insurance
The proportion of seniors in the civilian workforce continues to climb. As of 2022, more than 30% of people aged 65 through 74 are working or looking actively for work, the U.S. Bureau of Labor Statistics estimates.
The takeaway: If you or your spouse is “actively” working (AARP covers this key distinction in depth) and has health and dental insurance through an employer, don’t automatically enroll in Medicare. It may be cheaper for you to continue to get dental benefits through work.
9. Use fluoride
Fluoride, a mineral found naturally in water, is a cheap, safe supplement that helps reduce tooth decay, says the American Dental Association. As such, it may keep your dental costs down.
Fluoride is added in low levels to public water in many communities to help prevent tooth decay.
Ask your dentist if fluoridated toothpaste or mouth rinses are recommended for you, particularly if you drink bottled water or if your community water isn’t fluoridated.
10. Be careful with dentists’ credit-based payment plans
Your dentist may offer a payment plan. Before signing up, ask for a copy of the contract and take it home and study it. Interest payments and fees can potentially add substantially to the cost of dental care, so be sure you understand what you are getting into.
Self-insuring — simply putting a chunk of money into savings each month for dental costs — may be a financially safer plan.