When individuals reach the federal retirement age of 65, they become eligible for Medicare, a government health insurance program for the elderly and disabled, but nearly all oral health procedures are excluded from coverage through that program.
In 2012, 25.9 percent of the senior population paid for private dental benefits, according to a study conducted by the Health Policy Institute of the American Dental Association. An article in the Journal of Public Health Dentistry cited statistics from 2004 that found 70 percent of adults 65 and older did not have any dental insurance.
The dental options for seniors, many of whom lose coverage when they retire or if a spouse passes away, are paying for private insurance, purchasing supplemental insurance through Medicare or not having insurance and paying out of pocket. The latter option often occurs because low-income seniors become ineligible for the federal- and state-funded Medicaid program for the poor when they turn 65, and few qualify for dual coverage of Medicaid and Medicare.
Some of the only resources available for seniors who cannot afford the extra costs of private or supplemental insurance are community health centers.
In Westchester County, Open Door Family Medical Centers has locations that offer some dental services in Ossining and Port Chester. Janet Bozzone, director of dental services at Open Door, said there aren”™t many options in the county for low-income seniors.
Bozzone said her organization focuses on preventative care and the elimination of disease, which includes X-rays, diagnosis, taking care of cavities and dentures, but it doesn”™t “have the manpower or facilities” to provide more extensive dental care, like crowns.
Open Door does have a dental residency program with New York Medical College and Phelps Memorial Hospital Center that is offered at Open Door’s Port Chester location and Phelps Hospital.
“We”™re trying to not only provide advance training for the residents, but a service to the community as well,” Bozzone said of the residency program.
Optimus Health Care, a community health center with four locations in Fairfield County, is another affordable option for the elderly who cannot afford private insurance.
Maribel Rivera de Napoleon, the dental practice manager of Optimus, said it provides “comprehensive” oral care. The facilities do extractions, dentures and preventative care, much like Open Door, but also crowns and anterior root canal treatment.
Ludwig Spinelli, Optimus CEO, said when Optimus opened its first health center in 1976 there was a “100 percent need” for dental care because there were not that many dentists at the time. Today, it has a 380-person staff and serves roughly 2,000 patients per year in Fairfield County, 25 percent of whom do not have insurance, he said.
“Some of (our patients) are never going to be applicable” for insurance, Spinelli said, which makes “dental care an important piece of our delivery.”
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