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.


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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.
The final kind of dental insurance is indemnity dental coverage. These plans allow you to visit any dentist and they will pay a fee for the procedures you have done. They calculate a set amount that they’ll pay for each type of procedure and any additional amount would have to be paid by you out-of-pocket. They also have an annual maximum which can sometimes be higher than other types of plans. One of the downsides is that you have to pay for all the services upfront and submit paperwork in order to get reimbursed.
Dental plans will usually cover a portion of your costs on different types of dental procedures. Some plans focus more on preventative and basic dental care, but offer less coverage on major dental procedures. It's important to understand what's best for your dental health. If you routinely need a root canal or get cavities, you'll want a plan that provides better coverage on those types of procedures. In contrast, if you have relatively healthy teeth then you might not need to pay for the extra coverage.
One of their popular plans is the My Dental Plan that allows you to customize your plan for what you need. It has a $50 deductible per person. You can customize the plan for either one or two cleanings per year and choose to have preventative care covered at 80% or 100%. When it comes to basic care, they offer the choice of 50% coverage and 80% coverage. For major car, they cover either 50% or 0% depending on the plan you choose. Their annual maximums are either $500, $1,000, or $1,500.
*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.
By using this website, I confirm that I understand and agree to the applicable Privacy Policy and Terms of Service. I understand that by calling the phone number above I will reach a licensed sales agent. *Not connected with or endorsed by the United States government or the federal Medicare program. Medicare has neither reviewed nor endorsed this information. Copyright © 2018 Medicarehealthplans.com. All rights reserved. 5202 W. Douglas Corrigan Way, Suite 300, Salt Lake City, UT 84116. Medicarehealthplans.com is a free information source designed to help find insurance coverage. Whether you are looking for a Medicare Advantage Plan, a Prescription Drug Plan or a Medicare Supplemental plan, our licensed agent can help you find the right coverage options. We compile our data from multiple sources, which includes the government, non-profit and private sources. The rates and information displayed is for informational purposes only, and should not be construed as advise, consult, or recommendation. For specific plan details and further information, contact the carrier directly.
My plan covered cavity fillings, but an additional procedure (like a crown or an extraction) would have been costly even with insurance. Multiple appointments also took up a lot of time. I could have spared myself some of those cavities, and long hours in the dentist’s chair, if I’d got regular cleanings in earlier years (and, of course, flossed more often).
*The plan is insured by Delta Dental Insurance Company (Contract 1230) in AK, AL, DC, DE, FL, GA, LA, MD, MS, MT, NV, NY, PA, PR, TN, TX, UT, VI and WV, insured by Dentegra Insurance Company (Contract 1230) in AR, AZ, CA, CO, CT, HI, IA, ID, IL, IN, KS, KY, ME, MI, MN, MO, NC, ND, NE, NH, NJ, NM, OH, OK, OR, RI, SC, SD, VA, VT, WA, WI and WY, and insured by Dentegra Insurance Company of New England (Contract 1230) in MA. The plan is administered by Delta Dental Insurance Company. For Texas residents your Master Policy Form number is TX-AMD-MC-DPO-D-DC(DELTAUSA1-2005). These companies are financially responsible for their own products.
Learn more about:Dental InsuranceDental plans that fit your budget. Get and keep a healthy smile. Find PlansRelatedFinding the Best Dental Insurance in FloridaGetting Low-Cost Dental Insurance as a Self-Employed IndividualFinding Low-Cost Dental Insurance for Your Family as a Self-Employed IndividualFeaturedKey Health Insurance TermsObamacare 101: How Obamacare Health Insurance WorksHealth Insurance Products and Definitions var gf_global = {"gf_currency_config":{"name":"U.S. Dollar","symbol_left":"$","symbol_right":"","symbol_padding":"","thousand_separator":",","decimal_separator":".","decimals":2},"base_url":"https:\/\/www.ehealthinsurance.com\/resources\/wp-content\/plugins\/gravityforms","number_formats":[],"spinnerUrl":"https:\/\/www.ehealthinsurance.com\/resources\/wp-content\/plugins\/gravityforms\/images\/spinner.gif"}; Newsletter Sign up for our eHealth Newsletter email to receive updates that will help you! Email* This iframe contains the logic required to handle Ajax powered Gravity Forms. jQuery(document).ready(function($){gformInitSpinner( 1, 'https://s27829.pcdn.co/resources/wp-content/plugins/gravityforms/images/spinner.gif' );jQuery('#gform_ajax_frame_1').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_1');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_1').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;if(is_form){jQuery('#gform_wrapper_1').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_1').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_1').removeClass('gform_validation_error');}setTimeout( function() { /* delay the scroll by 50 milliseconds to fix a bug in chrome */ jQuery(document).scrollTop(jQuery('#gform_wrapper_1').offset().top); }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_1').val();gformInitSpinner( 1, 'https://s27829.pcdn.co/resources/wp-content/plugins/gravityforms/images/spinner.gif' );jQuery(document).trigger('gform_page_loaded', [1, current_page]);window['gf_submitting_1'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}setTimeout(function(){jQuery('#gform_wrapper_1').replaceWith(confirmation_content);jQuery(document).scrollTop(jQuery('#gf_1').offset().top);jQuery(document).trigger('gform_confirmation_loaded', [1]);window['gf_submitting_1'] = false;}, 50);}else{jQuery('#gform_1').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger('gform_post_render', [1, current_page]);} );} );if(typeof gf_global == 'undefined') var gf_global = {"gf_currency_config":{"name":"U.S. Dollar","symbol_left":"$","symbol_right":"","symbol_padding":"","thousand_separator":",","decimal_separator":".","decimals":2},"base_url":"https:\/\/www.ehealthinsurance.com\/resources\/wp-content\/plugins\/gravityforms","number_formats":[],"spinnerUrl":"https:\/\/www.ehealthinsurance.com\/resources\/wp-content\/plugins\/gravityforms\/images\/spinner.gif"};jQuery(document).bind('gform_post_render', function(event, formId, currentPage){if(formId == 1) {if(typeof Placeholders != 'undefined'){
A PPO, or preferred provider organization, is the most common type of dental insurance. This plan has arranged reduced rates with dentists. These dentists are called in-network because they will work with the insurance company. You can go out of network if you have a PPO plan, but you will not get the benefit of the reduced rates. It’s best to check to see if your preferred dentist is in-network before you buy insurance.

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.


© Delta Dental. This website is the home of Delta Dental of California; Delta Dental Insurance Company; Delta Dental of Pennsylvania; Delta Dental of New York, Inc.; Delta Dental of the District of Columbia; Delta Dental of Delaware, Inc.; Delta Dental of West Virginia, Inc. and their affiliated companies. For other Delta Dental Plans Association member companies, visit the Delta Dental Plans Association website.
Individual and family health insurance plans can help cover expenses in the case of serious medical emergencies, and help you and your family stay on top of preventative health-care services. Having health insurance coverage can save you money on doctor's visits, prescriptions drugs, preventative care and other health-care services. Typical health insurance plans for individuals include costs such as a monthly premium, annual deductible, copayments, and coinsurance.
Dental Health Maintenance Organization plans entail dentists contracting with a dental insurance company that dentists agree to accept an insurance fee schedule and give their customers a reduced cost for services as an In-Network Provider. Many DHMO insurance plans have little or no waiting periods and no annual maximum benefit limitations, while covering major dental work near the start of the policy period. This plan is sometimes purchased to help defray the high cost of the dental procedures. Some dental insurance plans offer free semi-annual preventative treatment. Fillings, crowns, implants, and dentures may have various limitations.
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There are few procedures that most insurance companies will not cover or only provide a discount for. Most individual dental insurance plans do not cover what might be considered cosmetic procedures such as tooth-colored fillings on molar or bicuspid teeth, dental implants or adult cosmetic orthodontics. The majority of dental companies will also limit how often certain appliances can be replaced and, in most cases, will not replace lost items. The limitations are published in the disclosures and contracts for the plan, many of which you can peruse online. Keep in mind that a new dental insurance plan is not going to cover an emergency you are experiencing right now; most have a waiting period of six to 12 months for major work. (However, some will waive the waiting period if you recently had dental insurance.) Dental groups that offer dental discount plans will let you use your benefits right away, but they only provide a discount and not full coverage. Full coverage plans will however cover your initial evaluation so you can start planning your dental procedures.
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.
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