AMAC Magazine Exclusive – By Sabrinah Cave
Most retirees are surprised to learn that Original Medicare doesn’t include routine dental care. This is critical to know, because as we age, the risk of gum disease1 and the need for major procedures like crowns or implants increases. Yet, there’s no safety net when you need it most. From routine care to oral surgery, dental insurance is vital—and here’s why.
How Dental Insurance Works:
Dental insurance typically covers an array of services that can be broken up into three categories: Preventative, Basic, and Major.
- Preventative Care: Includes routine care, such as oral exams, cleanings, and X-rays.
- Basic Services: Focus on restorative care, such as fillings and root canals.
- Major Services: Include oral surgery, crowns, implants, bridges, and dentures.
Preventative care is typically covered at 100 percent and basic services at 80 percent, but major services are often covered at lower amounts (30–50 percent). Plans usually include a benefit maximum as well, which is the most the insurer will pay on covered services for the year.
However, benefit amounts and covered services vary from plan to plan. Additionally, some services may be listed under a different category, e.g., crowns may be listed as a basic service under one plan and a major service under another plan.
Real-Life Scenario
Bob is overdue for routine dental care, so he visits his dentist. Bob’s dentist performs an exam and X-rays—both of which are completely covered by his insurance as preventative services. His dentist notices significant tartar buildup and also performs a deep cleaning, which costs him $50 as a basic service.
Here’s how much these services might cost without insurance:
The national average cost for a routine dental exam, including cleanings and X-rays, can cost up to $350, and the average cost for a deep cleaning is $242.2
*Actual cost varies based on geography, provider, and other variables.
Dental insurance isn’t just about cleanings—it’s about avoiding the $1,000 surprise bill for a single crown.
Dental insurance can significantly lower out-of-pocket costs, especially for procedures like crowns or root canals, which can cost hundreds or even thousands of dollars without coverage. Even for those with good oral health, dental insurance still offers long-term value by reducing the cost of preventive care.
Still not sure if dental coverage is worth it? The only way to find out for sure is to compare costs, potential usage, and benefits—and we can help! AMAC members have access to a dedicated dental team who can help you do the math so you don’t overpay for the care you need. Call 800-368-1523 to explore affordable dental coverage options for you and your family.
Visit amac.us/dentalgap for an instant dental quote!
Sources:
- Bob Kuska, “Probing Periodontal Disease,” National Institute of Dental and Craniofacial Research, March 28, 2024. https://www.nidcr.nih.gov/news-events/nidcr-news/2024/probing-periodontal-disease
- ASQ360° Market Research, October 2023 Cost Tables, found in “2023 Synchrony Average Procedural Cost Study for Cosmetic, Veterinary and Dental Practices Across the United States.
The Federal Government took our Medicare payments, from our paychecks, over our careers, then, when it was time for us to “get back” something for paying into the system, handed the wheel of the car to the Insurance Industry. They drive the car. They are about profit. Elder dental care would be very expensive, as it is in our twilight years that our dental needs are greatest. The same is true for vision care. Don’t expect that any Medicare Plan for vision or dental will benefit you much.
I have dental insurance through my advantage plan. Trouble is, I cannot find a dentist who accepts it,