One example of a Humana insurance plan is their Dental Loyalty Plus package that has a one time deductible of $150 per person or $450 for family. Unlike other plans where the deductible must be paid annually, their deductible lasts as long as you keep the plan. The maximum benefits of the plan in the first year are $1,000, in the second year are $1,250, and in the third year are $1,500. Preventative services are covered at 100%, basic services start with coverage at 40%, but coverage goes up to 70% by the third year, and major services start at 20% coverage and go up to 50% coverage by the third year.
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If you are on a policy that requires you to go to a participating provider, you should not be charged the difference between these two prices. A contracted dentist generally has an agreement with the insurance company to write off the difference in charges. If the policy allows you to go to a dentist or pediatric dentist of your choice, check the insurance company’s UCR fee guide against the fees that dentist charges. You may be required to pay the difference out of your pocket, however, you cannot put a price tag on quality dental care.
It is a far too common situation. You enroll in Medicare and have your medical and health needs covered. You feel good. Finally, you made a decision about Medicare. What about dental coverage? Your teeth matter, right? We all know when our teeth and gums hurt, everything hurts! Yet, Medicare and nearly all Medicare Advantage and supplement plans do not cover dental needs. If they do, coverage is usually limited to preventative care only. What will you do about fillings, bridges, and crowns? Luckily, we at My Family Life Insurance have many coverage solutions when it comes to dental needs. In this article, we discuss dental insurance, plan types, what to look for with affordable dental insurance, and the best dental insurance for seniors on Medicare.
For the most part, Medicare does not cover dental services with the exception of those services that are required due to another covered medical issue. There are exceptions but seniors should not expect Medicare to cover routine dental care or services such as cleaning, extractions, dentures, or even fillings. If you have an alternative insurance to Medicare B then that policy might cover dental, but again, that only works in certain circumstances, such as if you are not yet retired even though you are age 62 or older.
One example of a plan that is offered through eHealth is the Dominion Dental Services PPO Discount plan which has no deductible. They provide 100% coverage on most preventative and diagnostic procedures and 45% to 60% coverage on all other procedures including children’s orthodontics. They have no maximum annual benefit and they have no waiting period for things like cleaning, extractions, x-rays, and oral surgery but they have waiting periods but you have to use a dentist within their network.
Fee-for-Service plans: Like DPPO plans, dental Fee-for-Service plans require you to pay a percentage of the cost of treatment. Your insurance company will pay for the rest. Fee-for-Service plans typically offer the most freedom when it comes to choosing your dentist or dental practice. Fee-for-Service plans may also be more costly, since dentists are not typically reimbursed at the same rate as DPPO dentists.
Dental insurance plans typically cost more than discount plans, but they make actual plan payments to dental providers. Dental insurance plans usually have an annual benefit maximum of $1000 up to $3000 per year that can be paid out depending on the plan. Though insured dental plans may cost more than discount plans they may be a better solution if you need more dental care or have been accustomed to using dental insurance plans before.
2Delta Dental PPO is underwritten by Delta Dental Insurance Company in AL, DC, FL, GA, LA, MS, MT, NV and UT and by not-for-profit dental service companies in these states: CA – Delta Dental of California; PA, MD – Delta Dental of Pennsylvania; NY – Delta Dental of New York, Inc.; DE – Delta Dental of Delaware, Inc.; WV – Delta Dental of West Virginia, Inc. In Texas, Delta Dental Insurance Company provides a Dental Provider Organization (DPO) plan.

If you read our article on discount dental plans, you may think we are 100% against dental insurance. We are not. We simply know seniors can get sucked into paying high premiums with equally high out-of-pocket costs with no major insurance advantage. But, affordable dental insurance for seniors is possible that balances the right premiums, out-of-pocket costs, and coverage.
Each plan will provide dental coverage for a variety of dental needs, but are not always the same. What they might or might not cover includes dental services such as root canals, deep cleanings, and restorative procedures. When they do cover these services they do so only partially and the senior must either pay out of pocket or have a secondary dental insurance plan. Most plans for seniors pay for routine care, such as an annual cleaning, but require a copayment or co-insurance for other services.
Your Current Dental Health – Do you have pending dental needs, such as needing dentures, extractions, crown replacement, etc? This is all about the state of your mouth, teeth, and oral tissue today and for the next six months. That time frame is important because many dental insurance policies have a waiting period before you can use their benefits. For most, that period is six months.

They offer a quick online application and an online tool in order to make it easy to compare the best dental insurance options, and the promise that you can be approved in as little as 24 hours. Their dental insurance plans are for families, groups, or individuals. Policies start from $10.29 per month and premiums depend on the insurer that you choose.
Many provide as much as 100% coverage preventative services and then less on basic procedures usually 50% to 80%, and usually 50% to 0% on major care or things like crowns. Often there is some fine print with these plans and they do not cover certain procedures. They also have a maximum annual benefit and a deductible that you have to pay before they start coverage. There also can potentially be waiting periods on certain types of procedures but you don’t always have to get a referral to see a specialist.
Gum Disease. Your gum disease risk increases as you get older. The New York Times notes that in a study of people over 70 years old, 86% had at least moderate gum disease and over a quarter experienced tooth loss. It’s important to properly take care of your teeth, have a healthy diet, reduce stress, and refrain from smoking to reduce your risk of developing gum disease. Systemic diseases and certain medications can also affect the health of your gums.
Dental insurance companies sort the different types of dental procedures into different classes. There are five different types of classes. Class I is for diagnostic and preventative care which include things like x-rays, exams, and cleanings. Class II is for basic care and other procedures such as fillings. Class III dental care usually refers to major care and procedures such as dentures, bridges, implants, and crowns. Finally, Class IV dental procedures are orthodontics.
There can sometimes be significant differences between the dental insurance plans that employers sponsor and those that you obtain as an individual. One big (and obvious) difference is that usually employers pay for part or all of the dental insurance plan, whereas if you're buying a plan by yourself you have to pay for the whole thing. Some employers are also able to get a better deal because they're buying insurance in in bulk for all their employees. But, if you shop around, you could potentially get a plan that is similarly priced or even cheaper.

The next thing that you need to look at is the yearly enrollment fee that you will be charged. This fee can vary widely between insurers. For example, Humana only charges an enrollment fee when you first enroll and not in any year afterwards. Other insurers will charge you an enrollment fee every year. These fees are generally under $50 per year, so if you find an insurer that is charging you more make sure that it’s worth it to you because you’re saving on the plan elsewhere.

Dental savings plans are different than dental insurance. Dental savings plans provide you with a list of dentists who will give you a discount because you’re a member of the savings plan. Usually, these are quite generous discounts and can save you a significant amount of money on your dental care. Sometimes the discount can be well over 50% for things like preventative care, but it tends to be a little less for other types of care.


Under the federal law, dental benefits are an optional service for state Medicaid programs. States can include adult dental benefits in their Medicaid programs. Many states do provide dental benefits for adults; however the status and extent of those benefits vary by state and by year, depending on the availability of state funds to support such benefits.
Dental insurance companies divide benefits, services, or procedures into categories and refer to them with American Dental Association (ADA) 3-4 digit code. As an example, Preventative and Diagnostic procedures often include exams (ADA code 0120), x-rays (ADA code 0210), and basic cleanings or prophylaxis (ADA code 1110). Basic procedures often include fillings, periodontics, endodontics, and oral surgery. Major procedures often are crowns, dentures, and implants. Procedures such as periodontics, endodontics, and oral surgery may be considered major, depending on the policy.
Coverage begins at enrollment; there’s no waiting period. All applicants are accepted, even if you have previous dental work or ongoing issues, you’re guaranteed acceptance in the plan. You can even bundle a vision plan with it, for another $14 per month. All rates are guaranteed not to change for at least 12 months, but you can cancel any time you like.
If you don’t floss or brush every day, you will likely run into dental problems that everyone is susceptible to, including cavities, gum disease, tooth decay, and enamel erosion. However, there are some dental issues seniors are more at risk for than any other group of people. Seniors can develop these problems even if they properly take care of their teeth.

The Mayo Clinic advises that poor dental health significantly impacts your physical health, including causing heart disease and endocarditis, an infection of the heart’s inner lining. Diseases which often affect us as we age like osteoporosis, diabetes and rheumatoid arthritis, to name a few, frequently cause dental problems that eventually become too painful to ignore. Seniors often need more dental care than younger generations because of softening bones and teeth or a dry mouth, which can lead to an assortment of oral health problems. Regular visits to the dentist can save money down the road while reducing the risk of painful dental problems.


Before deciding to purchase dental insurance, talk with your dentist regarding the extent of your treatment plan. This way you can decide if you would be better off with or without dental insurance. A very important factor to remember regarding any dental insurance plan is that dental insurance is not at all similar to medical insurance. The majority of dental insurance plans are designed with the purpose of only covering the basic dental care around $1,000 to $1,500 (about the same amount that they covered 30 years ago) per year and is not intended to provide comprehensive coverage like that of medical insurance.
For those seniors who enjoy good dental health and are looking mainly for preventive care and basic services, Ameritas Dental may be a good option to consider. For those looking to save money, if you only need one preventive/maintenance checkup per year, you can buy a dental plan through Ameritas that will cost less than plans with more services. The company also offers a dental rewards program where you can roll over unused coverage from one policy term to the next if you did not use dental services during the year.

For freedom of choice, there are a few types of plans to consider including PPO dental plans and Indemnity plans. PPO dental plans generally allow members to see any dentist, but they also include a listing of In Network dentists. With PPO’s you typically get more value if you see an In Network provider, but you can still choose to see an Out of Network provider too. Though Out of Network providers can bill for additional charges if they wish.

While we conducted extensive research, we cannot tell you exactly what your new dental plan premium will be or what it will cover. Premiums vary by zip code, age, plan type and other factors. Our reviews can tell you generally what to expect from the dental insurance companies we reviewed, but we cannot predict your exact situation. To calculate average premiums we gathered quotes from numerous areas across the nation; we chose zip codes from large metropolitan areas and from smaller cities of around 150K. We looked for premium rates for one, two and three persons. We made note of the lowest and highest premiums quoted and excluded dental discount plans and preventive-only plans. The sample terms and conditions are common scenarios, but again, these vary depending on the plans available in your area.
It's possible to purchase a dental-only insurance plan. You'll have to pay a monthly premium, but the cost will be offset by lower out-of-pocket fees. Most of these dental plans require that you see an in-network dentist who may offer lower rates than out-of-network providers. Some plans let you go to any dentist (in- or out-of-network), but you may have to pay more for their services.
The next thing that you need to look at is the yearly enrollment fee that you will be charged. This fee can vary widely between insurers. For example, Humana only charges an enrollment fee when you first enroll and not in any year afterwards. Other insurers will charge you an enrollment fee every year. These fees are generally under $50 per year, so if you find an insurer that is charging you more make sure that it’s worth it to you because you’re saving on the plan elsewhere.
No matter which type of plan you choose, we recommend that you carefully review your contract so you know exactly what your insurance will cover. Additionally, in most cases your dentist's office will be familiar with what your insurance may or may not cover. Since many dental offices will require you to pay the estimated uncovered balance upfront, you will need to make sure you know what that is in advance so you can plan your budget. If you cannot cover the remaining balance you may want to ask if your dentist provides financing.
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