Since all dental insurance carriers are different, it is important to clarify which dental procedures fall under each specific category. This is important because some insurance plans don't cover major procedures and others have waiting periods for certain procedures. If you know that you will need major dental work that is not covered by a given plan, you should probably look elsewhere to find one that suits all of your needs.
We hoped you learned more about dental insurance for seniors. You have many affordable options. Need assistance or want to learn more? Feel free to contact us or use the form below. We would be happy to help you find an affordable insurance plan for you. Remember, we work in your best interests only. This is the only way we know how to work with our clients. If there is a better plan available that we can’t offer you, we would be happy to help you obtain or recommend that plan to you.
If you go to an out-of-network dentist, then the plan usually pays based on the UCR fee. For example, if the dentist charges $250 for the filling, but the UCR in your area is $150, you could end up paying more. In this case, $130 ($250 – $150 X (.80)). This also introduces the concept of balanced billing, which means paying the dentist the cost difference between their rate ($250 in this case) and the cost-sharing rate ($120).
Does this sound good? Maybe. You’ll pay for everything…at a discount. How does this compare to traditional dental insurance? In our opinion, you may end up paying the same or less, generally speaking. While you have to pay for preventative care, it is at a discount. Compare with dental insurance, which the preventative care is free but you generally pay a higher monthly premium.
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.
As a Medicare beneficiary, you are free to shop for a stand-alone private dental plan for seniors. Some dental plan types are PPO plans* and others are indemnity plans. A PPO stands for preferred provider organization. This is a type of plan that contracts with dental providers to create a network of participating providers. If you want to use a dentist out of network, you usually can for an additional cost. An indemnity plan allows you to visit almost any dentist you like with the plan paying a portion of your total charges. Indemnity plans are also called “fee-for-service” plans.
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.
The benefits of choosing MetLife are that they have a number of different plans available and they are well respected within the dental insurance industry. They have a broad network of dentists who work with them and they have significant coverage with a low deductible. The downside is that you have to visit dentists within their network in order to save.
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.
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.

Aetna’s dental discount network includes over 161,000 dentists, and Careington says over 100,000 dentists participate in their plan. We searched for providers from a less populated location in the U.S. and found no dentists from the Aetna plan while the Careington plan had four dentists, although the offices were located 100 miles from the zip we used. If there are no providers available in a reasonable distance from your home, you can nominate dentists, and Careington will contact them to request participation. Dental providers usually join the network within 60-90 days.


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. Special promotions including, but not limited to, additional months free are not available to California residents or on Fully Insured Plans. Note – not all plans and offers available in all markets.
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.
The cost estimates provided may be different from your actual costs for several reasons, including but not limited to, your unique dental circumstances and the decisions made by you and your dental professionals as to what services you will receive, deviations between the anticipated scope of services and the services actually provided, and the characteristics of your particular plan.
However, if your insurance does not cover cleaning and preventative care at 100%, then you will have to pay the remaining costs of your visit. This can cost anywhere from $20 to over $100 depending on the type of care you’re getting and the percentage covered. If you’re getting a PHMO plan, it is easier to estimate your costs since all procedures conducted in their network will have fees, but if you’re going to your own dentist then it will simply be a percentage of whatever they charge.
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.
But for many, the perceived high cost of dental insurance is one of the key factors that is keeping them from getting a policy. Luckily, there are a number of different options for people at different price points. According to the National Association of Dental Plans, the average annual cost of coverage in 2009 (the most recent year the survey was conducted) for a dental HMO plan was around $225 per year for an individual or $445 per family, the cost of a dental PPO plan averaged around $285 for an individual and $866 per family, and indemnity plans cost an average of $288 for an individual and $666 for a family.

If you go to an out-of-network dentist, then the plan usually pays based on the UCR fee. For example, if the dentist charges $250 for the filling, but the UCR in your area is $150, you could end up paying more. In this case, $130 ($250 – $150 X (.80)). This also introduces the concept of balanced billing, which means paying the dentist the cost difference between their rate ($250 in this case) and the cost-sharing rate ($120).
In addition to companies listed here, you can check out other options by using a dental insurance search engine, such as the one available at the Dental Insurance Store. There you can plug in your age and ZIP code and get a list of plans available in your area. Along the left side of the screen, you can select various options that may be important to you – such as “no waiting period.”
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.
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.
If you are changing insurance and want to continue with your current dentist, you can visit the websites of insurance companies you are thinking about signing up with and search to see if your dentist accepts the new type of insurance. However, sometimes these search results aren't updated or only show offices seeking new patients, so you'll want to verify by calling your dental office.
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.
The key to keeping your teeth healthy as a senior is properly brushing and flossing your teeth, as well as visiting your dentist regularly for checkups and cleanings. You want to make sure to brush your teeth at least twice a day with toothpaste that contains fluoride, according to Colgate. The American Dental Association (ADA) notes that fluoride prevents tooth decay and cavities.  It’s also important to floss once a day, says the ADA.

Discount dental plans are not insurance. However they provide a low cost alternative to dental insurance plans. Dental discount plans have a small monthly fee that allows you to receive substantial discounts for procedures with the plans’ In Network dental providers. With discount plans, you only pay the specific discounted amount for the procedures you have. These discounts can be 40-50% off typical retail costs for services. If the cost of care is a significant factor you may want to consider a discount dental plan with a carrier like Careington dental.
With an extensive network of more than 100,000 participating dentists at more than 300,000 locations nationwide, there is likely an in-network dentist in your area. When you combine the ability to choose your preferred dentist with the kind of comprehensive coverage available through one of the largest providers in the dental insurance sector, you’ll find Guardian dental is tough to beat.
Most full coverage dental insurance plans will cover two preventive maintenance visits per year without requiring a deductible payment. Most require a $50 deductible per person, per year to help cover costs beyond your preventive exams. If you need work done, most plans will cover a part of the costs. We looked at root canals specifically and found that the majority of dental plans will cover about half the cost, which may not seem like a lot, but paying half is better than paying upfront for an $800 root canal. However, keep in mind that most insurance policies, depending on your plan, top out at about $1000 to $1500 per year. Using conservative estimates that might be one or two root canals. If you need extensive work done you might have to pay the remaining amount out of pocket.
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