I could have paid the average of $360 a year for a dental policy in my twenties. Or I could have paid out of pocket for two dental exams, including cleanings and X-rays, which, in 2011, cost an average of $370 combined. In that case dental insurance wouldn’t have saved me much money. And if I went to a dental school or clinic for treatment, I could have saved even more on out-of-pocket costs.
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The Dental Care Cost Estimator provides an estimate and does not guarantee the exact fees for dental procedures, what services your dental benefits plan will cover, or your out-of-pocket costs. Estimates should not be construed as financial or medical advice. For more detailed information on your actual dental care costs, please consult your dentist or your Delta Dental.
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Another thing to consider when looking for dental plans for seniors is the waiting period some plans may have for certain services. For example, a plan may set a 3-month waiting period for an extraction. This means that if you get an extraction a week after enrolling in that plan, you usually won’t be covered. Some services may have longer waiting periods, such as 15 months, before the plan covers that service. This is why it is best to not wait until you have a dental emergency to enroll in a dental insurance plan.
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.
Estimating your possible dental costs may help you decide whether dental insurance would be financially beneficial. Dental insurance companies will show you a quote online so you can easily see what your premiums might be. You may want to compare your estimated yearly premiums to the cost of a year of procedures you want to have done. You can estimate how much your dental expenses might be either by talking with your dentist, or by researching costs online. You can use the estimates to help you decide whether you should pay out of pocket or plan your dental expenses based on your insurance coverage. Two resources for looking up procedure costs are The Fair Health Consumer Organization and the Guardian Insurance website. Estimated costs are sorted by zip code and will show a low and high rate so you can see a range of what a procedure may cost in your area.
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.
They have a popular dental PPO plan called MetLife 2-9 Dental. They negotiate fees within their network of dentist which are lower than average and cover over 400 procedures. They offer 100% coverage on preventative care, 80% coverage on basic care, and 50% coverage on major care with a $50 deductible. Their annual maximum coverage amount is between $1,000 and $1,500.
Medicare recipients are legally permitted to purchase dental plans on the ACA Marketplace, but the process isn’t easy. As noted in the section above, stand-alone dental plans are not eligible for subsidies. And in the states where the ACA Marketplace is run by the federal government, dental coverage is available only to those who also buy health insurance.
While some financial planners suggest dental insurance may not be worth paying for, we did the math to discover that it is usually worth it, provided you attend all of your allowable preventive exams and cleanings. We also learned that if you need any type of work such as a root canal or filling, you will definitely notice a cost savings. However, premiums vary greatly, not only by the type of plan, but by location and age. So you'll want to obtain a few quotes for insurance companies that provide coverage in your area. You'll also want to verify that your dentist accepts your chosen insurance before you sign up with a new provider.
Yes. Plans vary by state and not all discount or low-cost senior dental plans cover the same services. Some have limited services or only pay so much per year before they max out on benefits. Some may not cover routine care, such as cleanings. It is important to compare dental plans and look for value rather than just for lower monthly premiums. Your goal is always to find the best plan that fits your dental needs and budget.
Many seniors have dental health issues, and hope that by purchasing a standard insurance plan they will be able to afford to get treatments that they have been delaying due to cost. Unfortunately traditional dental insurance often does not cover preexisting conditions, nor will it pay to replace teeth that were lost prior to purchasing the coverage.
Generally dental offices have a fee schedule, or a list of prices for the dental services or procedures they offer. Dental insurance companies have similar fee schedules which is generally based on Usual and Customary dental services, an average of fees in an area. The fee schedule is commonly used as the transactional instrument between the insurance company, dental office and/or dentist, and the consumer.
*Examples only. These are the average costs the patient will pay per procedure with an in-network provider and are based on averages across Atlanta, Cincinnati, Los Angeles, Manhattan and Saint Louis. Actual costs and savings may vary by provider, geographic area, and service received. There are limitations and exclusions to the discount available. For example, general anesthesia, implants, and/or cosmetic dentistry are not discounted services. Upon purchase, refer to your policy for more information on the limitations and exclusions that apply. Coinsurance listed is for Prime Plan C.
With the rising cost of going to the dentist, many people are struggling with the decision of whether or not to purchase dental insurance. Whether you are considering buying dental insurance through your employer or independently, be sure to investigate several different plans and ask questions about the factors listed below. This information will help you choose the right dental insurance plan before signing on the dotted line.
In the United States, Participating Provider Network or PPO, also referred to as Preferred Provider Organization, is an organization governed by medical doctors, hospitals, other health centers, and medical care providers. This organization has an agreement with an insurer or the third party administrator to provide health insurance to the people associated with their client at reduced or low rates. Participating Provider Network plan may work similar to a DHMO while using an In-Network facility. However, a PPO allows Out-of-Network or Non-Participating Providers to be used for service. Any difference of fees will become the financial responsibility of the patient, unless otherwise specified.
A carrier recently told us that many seniors expect to carry over their dental coverage from their employer. Yet, that rarely happens. What does happen is that about 90% of seniors on Medicare don’t have proper dental coverage (American Dental Association). After filling out the Medicare paperwork, most seniors put dental insurance on the back burner. (And vision and hearing, too…we’ll get to those later.) And, why not? Your teeth are not hurting yet and they feel pretty good.
When you put all of this together, you end up with a set of convenient, affordable plans that will make it much easier to give your body the care it needs. At Dental Select, we know that your teeth, vision, and hearing are all important, and that’s why we have worked for years to make sure you have access to the care you need to take care of each of them. When you are looking for the best dental insurance for seniors, Dental Select is tough to beat. Enroll online today!
Savings plans are NOT insurance and the savings will vary by provider, plan and zip code. These plans are not considered to be qualified health plans under the Affordable Care Act. Please consult with the respective plan detail page for additional plan terms. The discounts are available through participating healthcare providers only. To check that your provider participates, visit our website or call us. Since there is no paperwork or reimbursement, you must pay for the service at the time it’s provided. You will receive the discount off the provider’s usual and customary fees when you pay. We encourage you to check with your participating provider prior to beginning treatment.
Dental health is an important part of your overall wellness, and not having insurance may tempt you to skip regular cleanings and checkups – a decision that could lead to serious dental health problems down the road. Spirit Individual Dental Insurance plans are designed to help fill these types of gaps by offering a variety of plans and price points.