Taking good care of your teeth and dental health is no doubt essential all your life. But, as you age, it becomes all the more important to get regular dental checkups and professional cleaning. If you’re concerned about the possible expense, rest assured that there are several insurance plans for seniors. The federal government has organized programs to assist people who are aged 65 years and above. So, do talk to your oral care practitioner about getting direct billing. Dental clinics that are a part of the program connect with the insurance provider to collect fees and other charges. Depending on the insurance plan you have, you could get most of the cost covered and avoid the need to pay cash.

Seniors May Need Specialist Dental Care

When looking for a direct billing dentist in Calgary, make sure the practitioner has the necessary training in senior dental care. That’s because elderly patients have unique needs and you’ll need a doctor who understands the challenges you face. Here are some of the particular issues you may deal with regularly. Do any of them sound familiar?

  • Arthritis causes pain and swelling in the joints and you might find it harder to brush and floss. Many seniors find that plaque and tartar seem to build up more quickly. The dental care practitioner will conduct a thorough cleaning and also perform polishing if needed.
  • Certain medications have side effects like dry mouth and lower production of saliva. As a result, you may find that you’re more prone to tooth decay and gum disease. That’s because oxygen-rich saliva works to destroy bacteria that can build up in the oral cavity.
  • Bone erosion can occur with aging and you might find that fillings and dental crowns are getting loosened. Schedule appointments regularly so your dentist can treat you before you lose the applications entirely. Direct billing can help cover the costs.
  • If you have problems like tooth loss, the practitioner will help you with restorative dental procedures or dentures for a better quality of life.
  • Seniors who have trouble brushing can opt for toothbrushes with extenders. Specially-designed flossing devices can help you reach the hidden sections of your teeth more easily.
  • Many elderly people develop cognitive degeneration as they age. Or, restrictions in mobility could make it hard to maintain dental hygiene. The doctor will make the necessary recommendations so you can work around the challenges. Caregivers assisting you with regular dental hygiene can also receive advice on how to help you.

Most Senior Care Practitioners Offer Easy Pay Solutions

One of the biggest problems that seniors face is affordability. Dental treatment can be expensive and many people are hesitant about going for regular visits. A practical solution is to get insurance programs that facilitate direct billing. You’ll also want to sign up with clinics that follow the new 2020 Alberta Dental Fee Guide. This fee structure outlines the expected cost of most dental treatments. Your insurance provider may cover 100% of the costs so you won’t have to pay cash. In case patients don’t have insurance coverage, clinics offer discounts and easy-pay options making dental care affordable.

Regular appointments with a direct billing dentist in Calgary are also essential for seniors because the dentist can identify the onset of several related health issues. For instance, the condition of your teeth can indicate illnesses like diabetes and osteoporosis or bone loss. It is also advisable to sign up with an oral care practitioner who can maintain a record of your dental history. This information may prove useful in case you need emergency dental services.

Understanding Dental and Optical Assistance for Seniors Programs

The Dental Assistance for Seniors program has several provisions to help seniors from low and moderate-income groups get dental treatment. This assistance can help you maintain a reasonable level of oral health and hygiene. The organization responsible for the smooth functioning of this plan is the Alberta Dental Service Corporation (ADSC). It works to coordinate the efforts of all the entities involved, including the patients who receive treatment, oral care practitioners, and government agencies. To avail of the benefits of the program and provision of direct billing, seniors must pass certain eligibility criteria such as:

  • You should be aged 65 years or above.
  • You should have been a resident of Alberta for at least 3 months at the time of applying.
  • Your annual income should be within the brackets outlined in the program.
  • You should be a citizen of Canada. Or, you should be a permanent legal resident of Canada.

At the time of applying for assistance, you’ll provide proof of age. This can be any document such as your birth certificate, passport, or naturalization certificate. An income statement provides proof of income for the past year.

Being Eligible for the Program Depending on Income Levels

If you’re eligible under the program, you can get dental treatment worth a maximum of $5,000 every 5 years. The program entitles you to a percentage of the cost via direct billing depending on your income levels. For instance,

  • For income levels up to $28,150, 100% or maximum coverage is available for a single person. Even if you’re married with a total household income of up to $56,300, both you and your spouse can get 100% coverage.
  • For income levels from $28,151 to $31,675, dental benefits can range from 10% to 99% or partial coverage for a single person. But, if you’re married, the program recognizes household income levels of between $56,301 and $63,350. You can your spouse can get coverage from 10% to 99%.
  • Seniors with incomes above $31,675 for singles and $63,350 for couples are not eligible for benefits.

Coverage Will Depend on the Kind of Procedures You Need

Elderly patients can get several basic procedures free of cost under the direct billing and Alberta dental care assistance plans. Here are some of the main treatments you can get:

  • Root canals and root planing
  • Tooth extractions
  • Oral inspection, x-rays, and any other basic diagnostic tests
  • Cleaning, polishing, and scaling to remove plaque and tartar
  • Repairing or inserting fillings
  • Treatment for oral trauma and pain of any kind
  • Inserting pins or dental rods designed to hold composite fillings in place
  • Basic dentures which may be full or partial
  • Treatments for gum diseases

If patients need additional or more extensive treatment, they may have to cover the costs on their own.

How Direct Billing Works for Seniors Assistance Programs

If you intend to get insurance coverage under any state programs, you can apply for claims by way of two direct billing processes:

Getting Treatment at a Direct Billing Dentist in Calgary

In case you get treatment from a dentist offering direct billing, the clinic will collect the cost of the procedure directly from the provider. You might have to pay only the difference if any. Direct billing dentists in Calgary like Macleod Trail connect with the ADSC electronically. Platforms like I-Trans Network for web users and the CSI ASYNC Network for Modem users allow practitioners to submit claims digitally.

Getting Treatment at Other Dentists

In case you get treatment at a clinic that does not provide the direct billing facility, you’ll cover the entire cost of the procedure. Having paid cash, you can later apply for reimbursement to the Alberta Dental Service Corporation. The dentist will provide the necessary form that you can later submit. Fax your request at this number: 1-780-426-7581 or e-mail the form to claims@adsc.org. If you would prefer to post your claim, mail the form to 200, 17010 – 103 Avenue, Edmonton, AB, T5S 1K7. Make sure to send in the form completed in English. Also, provide information about the procedures you’ve had and the cost for each.

Do keep in mind that certain dentists could charge you more than the maximum possible fee. In other words, their charges may be higher than outlined by the 2020 Alberta Dental Fee Guide. Or, the practitioners may call you for more frequent appointments as permitted under the assistance program. You might also need treatment that is not covered under the senior dental care program. If that happens, patients may have to cover the additional cost on their own. For this reason, it is best that you inquire about the possible fee charged by the doctor at the time of signing up. Rest assured that when you work with the Macleod Trail direct billing dentist in Calgary, you won’t have to worry about unreasonable costs.

Getting Compensation for the Costs

Once you submit a claim to the Alberta Dental Service Corporation, the agency begins processing your request right away. If you’ve applied for electronic compensation, you’ll likely receive the payment by deposit on the next Tuesday. If you’ve opted to receive a paper cheque, it will be dispatched via post the following Tuesday.

Seniors Have a Higher Risk of Developing Certain Dental Issues

As a senior, chances are that you develop certain dental conditions more readily than others. Here are some of them:

  • Tooth decay and cavities
  • Tooth loss
  • Sensitivity and pain when eating or drinking hot and cold foods
  • Gum disease
  • Dryness in the oral cavity
  • Thrush or yeast infections in the mouth typically caused by a weakened immune system

On your part, you can adopt certain hygiene practices to lower the risks and maintain dental health. You’ll find that you can cover the costs with direct billing and lower long-term expenses. Here are some of the habits you should include in daily life:

  • Choose dairy products and high-fiber foods in your daily diet, make sure you include lots of fruits and vegetables
  • Give up smoking or any other nicotine habit.
  • Restrict your alcohol intake
  • Make sure to clean your dentures every single day, whether they are partial or full dentures
  • Using an electric toothbrush will help you get rid of all the plaque if you find it difficult to hold and use a regular toothbrush.
  • Get your dentist to recommend a good antiseptic mouthwash and rinse at least twice every day.
  • Drink lots of water to remain hydrated so you can avoid dry mouth.
  • Coordinate your medicine intake with the general practitioner and identify any drugs that could have effects on your dental health. Find out if you can avoid taking them.

The best preventive measure is, no doubt, coming in for checkups regularly. Direct billing and senior dental care cover professional cleaning appointments. So, it makes sense to get expert care.

Maintaining Dental Health Helps You Avoid Related Ailments

An additional factor to keep in mind is that dental problems can cause related ailments. For instance:

  • Long-term gum diseases can result in a buildup of harmful bacteria in your mouth. If these bacteria enter your bloodstream, they can reach other organs in the body and cause damage. As a result, you could develop problems like heart disease, diabetes, and respiratory problems like pneumonia.
  • Bacteria damages your gums so they’re not strong enough to support your teeth. Loosened teeth and tooth loss will make it hard for you to eat properly. Your health could deteriorate when your body does not get adequate nutrition.
  • Experts have linked oral health problems with a higher risk of developing blood clots. In turn, the clots could trigger strokes.

Taking care of your teeth helps you maintain not just perfect oral health, but you’ll also avoid related problems. Great teeth translate into good health and a better quality of life.

Stop by at Our Direct Billing Clinic in Calgary, Macleod Trail Dental

If you would like more information about how to take care of your dental health, contact our experts at Macleod Trail Dental. Our team members will direct you on the best way to get direct billing or recover your claim. Spend some time chatting with our dentist, Dr. Jennifer Silver, and she’ll help you will a complete list of the procedures you can get. Call this number: (403) 253-1248 and put forward your queries if you cannot visit right away. Or, you can choose to add your questions on this page and we’ll get in touch with you.

References:

  1. Dental and Optical Assistance for Seniors
  2. All Resources
  3. Best Dental Insurance for Seniors

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Dr. Jennifer Silver is one of the top dental surgeons practicing in Calgary, Alberta using an innovative multi-disciplinary approach to helping her patients. She believes in offering expert advice and make recommendations to patients just as she would to a family member. Dr. Silver collaborates with a large network of specialists and taps into their expertise to provide holistic care. 

Dr. Jennifer Silver has earned a Doctor of Dental Surgery degree from the University of Melbourne, Australia. Her academic qualifications include deans honours list, an oral surgery award and best research project. Before attaining this degree, she graduated with honors from Dalhousie University’s Dental Hygiene Program and worked in the sphere of dentistry for 10 years. Dr. Silver is currently helping patients with dental issues such as TMJ pain and sleep apnea in addition to dentistry. She is keenly interested in constantly upgrading her skills and hopes to gain additional training in oral surgery in the future.