The insurance industry has started to acknowledge the important connections between dental and medical health, which were once considered entirely separate.
Medicare, particularly Medicare Advantage, now includes coverage for dental cleanings. This change is significant for senior citizens, as many are unaware of this new benefit. These cleanings can help prevent what Dr. David Niles describes as “horrifically hard-to-fix problems.”
Dr. Niles, a dentist at Dental Care at Woodland Crest in Waunakee, recently visited the Waunakee Senior Center with Don Trippie, the operations manager for the dental office. During their visit, they found that most seniors did not know about the Medicare coverage update.
Trippie, who has extensive experience in insurance, explained that before 2015, senior citizens had to pay high premiums to add dental coverage. However, this has changed.
“Even very basic plans now cover cleanings,” Trippie said. “The insurance companies aim to cover just the basic cleaning. If they can eliminate infections, it will contribute to long-term health.”
Cleanings are crucial for maintaining healthy teeth, according to Dr. Niles. As people age, gum recession can occur, exposing the roots of the teeth. Without regular care and good dental hygiene at home, including the use of home fluoride and professional fluoride treatments, cavities can form on the roots, making them harder to manage.
In the past, dental and health insurance were seen as entirely separate. Now, there is a growing recognition of the link between dental health and overall well-being. Dr. Niles explained that poor dental health can impact people with heart problems, as plaque and bacteria in the mouth can affect heart valves.
Medicare Advantage plans, whether through Humana, United Health Care, Blue Cross Blue Shield, or other providers, offer basic preventive dental coverage. Trippie advises senior citizens to ask their dentists about what is covered when they make an appointment, as most dental offices are familiar with these plans.
Some plans also provide coverage for tooth extractions or replacements, though this often involves a copay. “Usually, it’s a copay, so about 20% of a major procedure might be covered,” Trippie said.
Dr. Niles aims to inform older adults about the available coverage to prevent more complex health and dental issues in the future. “It’s about longevity and quality of life,” he said.