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.
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.
Almost all dental insurance companies use what is called a Usual, Customary, and Reasonable (UCR) fee guide. This means that they set their own price that they will allow for every dental procedure that they cover. This is not based on what a dentist actually charges, but what the dental insurance company wishes to cover. For example, your dentist may charge $78 for a dental cleaning, but your insurance company will only allow $58 because that is the UCR fee that they have set.
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.
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Enhanced dental policies for seniorsSome dental insurance policies pay for part of the costs for services beyond routine exams and fillings. Some examples include (but aren’t limited to):Endodontics: Root canals, or the removal of a tooth’s decayed or diseased pulp, are the most common use of endodontics. Your family dentist can sometimes perform this repair, or he or she may refer you to a specialist.Periodontics: Periodontal disease comes in many forms and could end up destroying supporting bones around the teeth. Treatment may include the placement of dental implants and treatment for inflammation. A specialist is often required.Dentures: Being fitted for dentures typically requires many extractions, making it a major procedure, possibly involving several visits. Some family dentists now fit patients for dentures. Specialty offices are more familiar with the process and sometimes offer a faster turnaround.Implants: Some adults who have lost a small number of teeth due to an accident or decay might get dental implants. Implants may eliminate the need for a bridge since the implant looks, feels, and works like a regular tooth. An oral surgeon rather than your family dentist typically does this procedure.Orthodontia: This type of service involves braces to align crooked teeth. Most family dentists offer orthodontia.Cosmetic services: Bonding, whitening, and veneers are sometimes covered under certain dental policies. Many family dentists offer whitening.  Types of dental plansThere are two major types of individual dental insurance plans that may apply to seniors:Managed-care plans (often preferred provider organizations, or PPOs) negotiate fees with specific providers. These in-network providers request only your portion of the cost and file any necessary paperwork on your behalf. Procedures performed by out-of-network providers are sometimes covered, but often at a lesser amount.Indemnity plans often include a larger group of providers and you may be able to see the dentist of your choice. The drawback is that patients are often required to pay 100 percent of the bill up front and then file a claim for reimbursement for the covered procedure.You can get help choosing an individual dental insurance planDon’t wait until you feel discomfort to get dental insurance. Many seniors take daily medications that cause dry mouth, which can lead to cavities. Inadequate nutrition can also affect your dental health, reports the Columbia University College of Dental Medicine.Keep in mind that some health problems, like pneumonia and insulin resistance, may be triggered by poor dental hygiene. Research has even found a connection between gum disease and heart disease, Intellihealth News Service reports.If you’d like to explore your options for individual dental insurance plans in your area, just click the button on the right side of this page. You can also request our newsletter in the lower right side of this page if you want to stay up to date on with health and insurance-related updates.This article is for informational purposes only. Nothing in it should be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine. In addition, this information includes just some factors to consider when selecting insurance and may not reflect the provisions of any particular insurance product. Always carefully check the provisions of any insurance product you have or may consider purchasing. wp_cta_load_variation( '10789', '' )#cta_container{ border: 1px solid #dbdbdb; border-radius: 5px; } #wp_cta_10789_variation_0 #cta_container #content {background: transparent;}
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In general the dental insurance companies at the top of our review list provide a range of plan options to numerous areas of the country. We also considered average yearly preventive care costs across numerous zip codes and compared that number to possible yearly premium costs. This helps predict whether the premium costs would, on average, be less than the cost of preventive care paid out of pocket. Keep in mind that co-pays and other small fees might also determine whether you will break even by paying for dental insurance, but our numbers can give you a general idea of what you can expect. It was not surprising to learn that those who charge a higher premium may cover more and those with a lower premium might cover less. This means that if you pay more monthly you might receive more complete coverage, and if you pay less per month you might be expected to pay a bit more during the time of treatment. So you'll need to decide whether you want to pay more per month or make up a bit of the difference when you visit your dentist.
Depending on the type of insurance you’re looking at, the network of your dental insurance provider could be crucially important. Check to see how many dentists they have in their network and if your current dentist is in it or if there is a dentist who has an office near you that you would want to go to. Another thing to consider is whether the insurance provider will let you go see dentists outside their network, what the costs will be, and whether you need a referral when you need to see a specialist.
UnitedHealthcare has a large number on in-network preferred providers, over 200,000, so you won’t have any trouble finding a dentist in the plan. Cleanings and X-rays are covered 100 percent. Here are the charges you pay for basic services: exam - $25; root canal - 50 percent; fililngs - 30 percent; extractions - 30 percent. The coverage has no age maximum limitations. Deductible limits are $50 - individual, $150 - family of three with a 6-12 month waiting period for certain services. Cleanings and X-rays are covered with zero co-pay or deductible twice yearly.

Medicare Advantage plans may offer routine dental care. Medicare Advantage is another way to get you Original Medicare (Part A and Part B) benefits from a private insurance company. A Medicare Advantage plan may offer routine vision as well as prescription drug coverage. If you have a Medicare Advantage plan you have to continue paying your Part B premium. Medicare Advantage plans must cover everything that Original Medicare covers except for hospice care which is still covered by Medicare Part A. The extent of the Medicare Advantage dental coverage may vary from plan to plan.


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.
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