Seniors residing in Long Term Care (LTC) facilities have unique dental needs. Finding the right coverage at the right price may be difficult if you are on a fixed income or are a Medicaid recipient. These limitations may have caused you much uncertainty, but if access to care is your greatest concern, you now have options with the DentalSure dental plans.
DentalSure has contracted with providers who have extensive experience providing dental care, including onsite services. These plans are specifically tailored for the population residing in the LTC community. Feel confident knowing that you have the flexibility to seek treatment from a large selection of contracted dental providers in your community.
What popular preventative dental services care can I expect from DentalSure’s plan?
DentalSure plans are full coverage dental plans. For those who are Medicaid recipients collecting social security or a pension, you may be eligible to obtain an insurance plan at no additional, out of pocket expense for the duration of your LTC stay. There are no copayments or deductibles either!
The plan coverage includes:
Preventative Care
Regular visits, cleanings and fluoride application (NOT JUST FOR KIDS!)
Basic Restorative Care
Periodontal care, fillings and extractions
Major Restorative Care
Full coverage crowns, complete and partial dentures
As a DentalSure member,
you are entitled to:
Exams and Cleanings every 6 months
Eligible for crowns and dentures following six (6) months of active, paid premium payment
Denture replacement after three (3) years (not the typical five (5) and seven (7) years common with other dental insurances)
DentalSure Coverage
Contracted with On-Site Dental Care
DentalSure has dental teams that may be available to provide onsite dental care.
Comprehensive Plans
We provide a comprehensive dental coverage plan for the LTC resident with a limited budget.
No Copay or Deductable
Medicaid recipients may incur zero out of pocket cost for the policy.
Your Choice
Our plans offer you a vast selection of offices in your community, possibility of on-site care and a selection of annual maximum coverages that may make the most sense for you.
How does this work?
How can elderly long term care residents who are enrolled in Medicaid pay for the dental care they need? Fortunately, a solution known as Incurred Medical Expense (IME) billing can help the majority of long term care residents who depend on Medicaid afford to pay for the dental treatment they need without imposing additional costs on providers.
Residents who are eligible for Medicaid use their Social Security check and other income to pay their monthly nursing home costs. When the Incurred Medical Expense (IME) option processes, the resident’s monthly income pays for dental services instead of the nursing home. The Medicaid case worker will increase the amount Medicaid pays that month to the nursing home on behalf of the resident. The nursing home still receives full payment. Residents or their representatives must first make arrangements with their caseworkers to reduce monthly payments toward expenses at the nursing home for one or more months, and then are authorized to use those funds to pay for medically necessary dental care.
If you are not a Medicaid recipient, you will have to cover the cost of the plan as a private pay expense.
Click here to receive more information about DentalSure’s insurance plans.