For the most part, Medicare does not cover dental services with the exception of those services that are required due to another covered medical issue. There are exceptions but seniors should not expect Medicare to cover routine dental care or services such as cleaning, extractions, dentures, or even fillings. If you have an alternative insurance to Medicare B then that policy might cover dental, but again, that only works in certain circumstances, such as if you are not yet retired even though you are age 62 or older.
Often, there is no waiting period in a group plan, like one offered by an employer. Of course, if you were eligible for a company-based plan, you probably wouldn't be shopping around on your own. However, the same privilege might be had in a group plan offered through an organization such as AARP.  With their plans, there's no waiting period for preventative services, at least.   

Our health benefit plans, dental plans, vision plans, and life insurance plans have exclusions, limitations, and terms under which the coverage may be continued in force or discontinued. Our dental plans, vision plans, and life insurance plans may also have waiting periods. For costs and complete details of coverage, call or write Humana or your Humana insurance agent or broker.
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.
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.

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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.
Surgery to correct an abscessed tooth is usually considered a health issue and medical insurance covers the cost. Procedures to correct trauma to the mouth are considered medical and not dental, even if lost teeth are involved. Our best advice is to talk to both your medical and dental insurance carriers to determine where coverage falls, so you are prepared for out of pocket costs.
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).
To begin using the Dental Care Cost Estimator tool, click the Agree button below. By clicking, you agree that you have read the information below, are accessing this information for purposes of determining treatment cost estimates for dental care services you are considering receiving, and will not use the information in this tool for a commercial or anti-competitive purpose. The costs provided in this tool are estimates only and are not a guarantee of payment or benefits. Your actual cost may be higher or lower than the estimate for various reasons.
MedicareWire.com is an independent research, technology and publishing organization. We are not affiliated with Medicare, Medicare plans, insurance carriers, or healthcare providers, nor are we compensated for Medicare plan enrollments. We are affiliate with the dental savings plans mentioned on this page and may receive compensation if you join a plan. For more information, see our disclosure page.
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;}
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.
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.

This is more affordable than dental insurance and there are over 5,400 dentists currently in the Carrington network. The Carrington plan provides a discount that’s usually over 50% on preventative and routine procedures with smaller discounts on other types of procedures. The price for treatment will vary from state to state and affect the percentage of your discount, but some examples of discounts include 51% off a routine check up, 51% off the extraction of a tooth, 50% off a dental cleaning, and just 20% off adolescent braces.
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.
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.
If you are a senior or are approaching retirement, you may be surprised to find out that Medicare does not provide coverage for routine dental care. Medicare mainly covers medical treatments, but does not provide any assistance for routine dental care such as bi-annual exams, cleanings, or even major services like bridges or dentures. This leaves it to seniors to search for a dental plan that can meet their coverage needs.
You want to make sure that the plan that you get has great customer service so that if you have a problem you will be able to get the help that you need. Check their website to see whether they have a phone number, e-mail address, or instant messaging service that allows you to contact them. Do a quick internet search to see what people are saying about their customer service.
Most dental insurance companies have a waiting period after your application is accepted. This practice is so the customer doesn’t wait until they have accumulated the need for several procedures to buy and use dental insurance to cover the costs. Most plans have a waiting period for some procedures but not others, like a regular checkup. One of our best dental insurance companies has no waiting period for just about any procedure.
Medicare Health Plans is more than just Medicare plans! We work with seniors for all of their insurance needs. One of the most common types of insurance that seniors ask about is dental insurance. Since routine dental care is not included in Medicare and the “gateway” to your body is too important to ignore, seniors want dental insurance options. We represent multiple carriers and plans and believe we have the plans that will best fit your needs.
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.
The best way to take care of your teeth is proper maintenance, and Dental Select’s senior dental plans cover 100% of preventative costs. This includes two professional cleanings each year, as well as exams and x-rays. Most of the costs of basic procedures are covered as well, such as fillings, dentures, and even oral surgery. Better yet, there are no waiting periods, meaning that your plan is effective on the first day of the month following your enrollment.
Most dental insurance companies have a waiting period after your application is accepted. This practice is so the customer doesn’t wait until they have accumulated the need for several procedures to buy and use dental insurance to cover the costs. Most plans have a waiting period for some procedures but not others, like a regular checkup. One of our best dental insurance companies has no waiting period for just about any procedure.

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.
Other factors can affect your yearly dental expenses as well. Unfortunately, senior premiums are usually more and youth orthodontics may also cost more. Smokers are usually quoted higher premiums as well. Monthly premium rates vary greatly by region and area. We found that within the same insurance company rates may vary by as much as 30 percent depending on the zip code.
Dental insurance companies sort the different types of dental procedures into different classes. There are five different types of classes. Class I is for diagnostic and preventative care which include things like x-rays, exams, and cleanings. Class II is for basic care and other procedures such as fillings. Class III dental care usually refers to major care and procedures such as dentures, bridges, implants, and crowns. Finally, Class IV dental procedures are orthodontics.

Since buying cheap dental insurance will mean that going to the dentist could cost you more, you might also be less likely to go to the dentist or you could put the visit off if you have a problem. This could lead to bigger issues with your dental health which could lead to more expensive procedures and treatment. For example, if you put off treating a cavity, you could end up needing a root canal.


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One example of a plan that is offered through eHealth is the Dominion Dental Services PPO Discount plan which has no deductible. They provide 100% coverage on most preventative and diagnostic procedures and 45% to 60% coverage on all other procedures including children’s orthodontics. They have no maximum annual benefit and they have no waiting period for things like cleaning, extractions, x-rays, and oral surgery but they have waiting periods but you have to use a dentist within their network.
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.

No individual applying for health coverage through the individual Marketplace will be discouraged from applying for benefits, turned down for coverage, or charged more premium because of health status, medical condition, mental illness claims experience, medical history, genetic information or health disability. In addition, no individual will be denied coverage based on race, color, religion, national origin, sex, sexual orientation, marital status, personal appearance, political affiliation or source of income.
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