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.

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.
DHMO's are similar to HMOs in that their plans connect you with a network of dentists who give you care for a low monthly premium. With DHMO plans, you are required to go see dentists who are in their network, but in return you have lower costs, and no claim forms to fill out. DHMOs are great for preventative care and basic procedures. Some downsides include that there can be wait times if you need major or restorative dental care and some DHMOs don’t cover this types of treatment. You also need to go see your primary care dentist and get a referral to a specialist in order to get some specialized care.
More than 90 percent of dental insurance policies carry a “missing tooth clause” or a “replacement clause.” Many include at least one of these clauses, but most have both. A missing tooth clause protects the insurance company from paying for the replacement of a tooth that was missing before the policy was in effect. For example, if you lost a tooth before your coverage started and later decided that you would like to have a partial, bridge or implant, the insurance company would not have to pay for that service if they have a missing tooth clause in the plan. A replacement clause is similar except that the insurance company won’t pay to replace procedures such as dentures, partials or bridges until the specified time limit has passed.

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.
When you near the age of 65, you need to sign up for Medicare. However, Medicare does not cover preventative dental care or other procedures such as fillings, tooth extractions, dentures or other dental devices. If you have a complicated or emergency dental procedure that requires hospitalization, Medicare Part A will likely cover the cost, but it is obviously preferable to avoid hospitalization if you can with regularly-scheduled dental care.
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.

[1]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. Note-not all plans and offers available in all markets. Special promotions including, but not limited to, additional months free are not available to California residents.
Nothing on this website guarantees eligibility, coverage, or payment, or determines or guarantees the benefits, limitations or exclusions of your coverage. For a complete description of the details of your coverage, please refer to your coverage documents. Estimates may vary depending on your benefit plan and the state you live in. Claims will be processed when received according to your plan provisions. 
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.
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.
Another kind of dental insurance plan is a DPPO which is similar to a health insurance PPO plan. What they do is they work out lower rates with dentists that are in their network who are often referred to as their preferred providers. With this plan, you can visit a dentist outside of your network, but you will not be able to get these low rates and you will likely end up paying more. Many DPPOs provide coverage of preventative care, basic procedures, and major procedures, but they only provide a percentage of this care for each.
Different companies provide various percentages of coverage in these areas. For example, one insurance provider might cover 100% of the cost of Class I services while another might only cover 80%. Yet another plan might not provide Class IV or orthodontic coverage, but provide coverage in all other areas. It’s important that you understand what services are covered before signing up for a plan.
PPO Plan A is the most comprehensive plan with the highest number of services covered and still has a modest premium. PPO Plan A covers three cleanings and exams per year at no additional cost when visiting an in-network provider. There are no exclusions for most pre-existing conditions and dental implants are available after 1 year of continuous coverage. The annual deductible is $50 with an annual maximum of $1,500. You are allowed to visit any licensed dentist but with save money through using a preferred in-network provider.
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.
Like most kinds of health or ancillary medical insurance, there are deductibles involved in dental insurance. Generally, the deductibles are per individual or per family depending on your plan. Some companies require that you meet the deductible on each member of your family while others have a family amount that you have to hit – no matter who the person receiving the care was. Deductibles can range anywhere from $100 to $500 or more. Obviously, the higher your deductible, the less likely you’ll be to take full advantage of your insurance.
Examples of dental costs with the Careington 500 plan are $15 for an oral exam, $31 for a cleaning, $483 for a crown and 64 percent off of dentures. The prices quoted on the website are in the Fort Worth, Texas area, with savings of 60 to 74 percent off dental services and 20 percent off orthodontia. Cost of procedures may vary depending on your location.
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.

Another downside of buying your own dental insurance is that you might not be able to afford the same type of coverage, which means that you could potentially have fewer benefits than you would if you had gotten it through your employer. That might mean that you have less access to certain types of treatment or that in order to get an affordable plan with good coverage, you’ll have to choose one where you have to stay within the plan’s network.
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.

Carrington is a provider of discount programs for health and wellness services. It was started in 1979 and is based in Frisco, Texas. Carrington does not provide dental insurance, but rather dental plans where you can get discounts on affordable dental care by becoming a member. You have to pay monthly or annual premiums for your discount plan, but it can be as cheap as $8.95 per month or $89 per year.
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.
The reason why so many are uninsured might be because the economy is shifting towards more contract work, consultants, and freelancers. That’s left many people without an employer to pay the bill for things like health insurance and dental insurance. At the same time, many employers are cutting back on the benefits that they’re offering or shifting their benefits. Dental plans, which used to often be paid completely by the employer, might now be optional or require the employee to pay a significant portion of the costs. In that case, it could make more sense for you to shop for a plan that is a better fit for your needs and pay for your insurance yourself.
How you define “cost” is important. Generally a single plate – upper or lower- costs between $1,200 and $3,800. So, for a full set of dentures could cost in the $7,500 range. Those higher costs usually include other services such as extractions, mold production, and fittings. Again, the actual cost is dependent upon the senior’s oral health, and the amount of service needed. Don’t be afraid to shop around from one dentist to the next to see if there is a price break.
When you near the age of 65, you need to sign up for Medicare. However, Medicare does not cover preventative dental care or other procedures such as fillings, tooth extractions, dentures or other dental devices. If you have a complicated or emergency dental procedure that requires hospitalization, Medicare Part A will likely cover the cost, but it is obviously preferable to avoid hospitalization if you can with regularly-scheduled dental care.
One of their popular dental plans is the DentalGuard Preferred Plan. It provides 100% coverage on preventative and basic services, and 0% coverage on major or orthodontic care. If you have a premium plan, you can receive 50% coverage on those services. They do have an annual maximum of $1,000 and limits on how many cleanings or maintenance procedures that you can have in a one year period.
Our dental insurance plans offer affordable options for dental coverage. The plans have low deductibles to satisfy and multiple options for the maximum amount they pay each year. Our dental insurance plans offer lifetime deductibles (not calendar year), there are no benefit waiting periods, three cleanings are covered per year, adult dental implants are covered, and you can select from various maximum benefit amounts.
×