Perhaps you have already laughed ruefully, recognizing what an oxymoron that headline is.
Unless you are wealthy in your old age, in the United States, dental care beyond much more than an annual cleaning is not personally affordable and traditional Medicare specifically excludes it (although some Advantage plans cover some dental work).
As the medicare.gov website explains:
”Medicare doesn't cover most dental care, dental procedures, or supplies, like cleanings, fillings, tooth extractions, dentures, dental plates, or other dental devices.
“Medicare Part A (Hospital Insurance) will pay for certain dental services that you get when you're in a hospital. Part A can pay for inpatient hospital care if you need to have emergency or complicated dental procedures, even though the dental care isn't covered.”
In a post last week, I tried to make light of the difficulty I've had being in public without my denture. The reason for not wearing it was, as I explained, that
”...the entire length of gum on one side of my mouth swelled to a gargantuan size. The dentist supplied two kinds of antibiotics for the infection and after two weeks, it is nearly cleared up.”
Not completely. Nearly. The small amount of swelling that remains means the denture still doesn't fit yet and I'm stuck with no upper teeth for a few more days - a bummer in any case but particularly so as my Aussie friends, Peter and Norma, arrive this afternoon.
Worse, this turned out to be a great deal more than the simple, though large, infection I thought it was. As the dentist explained, it had traveled to my sinus and could, from there, enter my brain – potentially a life-threatening event.
Before now, I had no idea such a terrible thing exists. Then, still more bad news: There are a couple of smaller infections in my lower jaw and some other problems that require oral surgery, implants and a new (and better) kind of upper denture.
If I don't have this work done, the dentist and perio guy both told me, infections will continue to erupt probably more frequently and I will lose some (or all) of my remaining teeth.
This is not a surprise to me. I've heard it before but have neglected my mouth for several years because the last time I got an estimate for the needed work, the cost was about two-thirds of my annual income.
It's money I don't have lying around and my income obviously is not enough to pay as I go meaning, also, that there is no hope of saving enough in even five years and maybe not ten – obviously not a useful time frame in regard to teeth and infections.
On Tuesday this week, I met with the dentist to determine the work to be done to give me a healthy mouth, what the most cost-effective way to do it is and to come up with a bottom-line price.
The number brought tears to my eyes: It is about the same as a new, low-end BMW and way more than a year's income.
I fibbed three paragraphs up. I do have money that could pay for this but it certainly is not just lying around.
After the 2008 crash decimated my small savings, what is left is what I call my end-of-life fund. If it comes to needing full-time care in a nursing home, this would cover it for two, maybe three years by the end of which I would hope to be dead.
In no way is the fund meant for dental work but it is there, and I can use what would be a large portion of that fund for my teeth. I would just need to hope for a quick death.
“How do you get economical dental care once you use Medicare for your medical needs? I've paid for 2 "initial exams" this year, but can't afford the "plans" either dentist came up with. To go to yet another one, I'll again have to pay for the initial exam.
“I'm not yet eligible for Clinics, for those who have no resources, but if I pay for these plans, in a year I will be broke. Already being 72, I don't see investing all my savings into my teeth. Any suggestions?”
When, on Tuesday, I nearly passed out at hearing the price of the needed work, the dentist told me that I might qualify for low income dental coverage which, he said, only three or four states, including my own, offer.
I spent most of Tuesday afternoon tracking it down only to find that my income is not low enough for me to be eligible. Then I spent another two hours checking an Oregon program for stand-alone dental plans anyone – Medicare subscribers as well as others – can purchase.
There were a couple of plans with premiums I could actually afford but they did not cover any – not even a portion - of the kind of work I need done.
So I am back to the end-of-life fund. I am fully aware of how lucky I am. I may not have much income, but I own my home with no mortgage. I own my ten-year-old car with only 37,000 miles on it. I have no debt. My credit card is a convenience only, paid off each month and I live quite comfortably.
My heart goes out to Barbara and the many thousands of other elders who cannot afford even basic dental care. The best I can suggest is to diligently mine the possibilities.
Does a local dental school take patients for no or minimal cost? Do you live in a state like mine that offers a dental program if your income is low enough? Can you find a stand-alone dental program you can afford?
Does anyone reading this today have other suggestions? Because the fact is, untreated dental problems cause serious health problems.
The real answer to this is, of course, that the United States, like every other civilized, developed nation, needs to offer universal health care including dental. I suspect that won't happen in my lifetime.
At The Elder Storytelling Place today, Arlene Corwin: The Poet Pondered