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.
The short answer here is that there isn’t one. In fact, a better question to ask is “What is the best dental insurance for me?”. One key point that is important for seniors to understand about any type of insurance is the fact that we are all unique and individual. When you consider dental insurance your choice should be 100 percent about you. Even the best plan for your spouse might not be the best plan for you.
You’ll want to go to an in-network dentist as they usually have better, contracted rates. We’ll show an example of that in a minute. Cleaning or preventative care visits are typically covered at 100%. Basic or major services visits are typically covered at 80% and 50%, respectively. What does this mean? If you go to an in-network dentist for a tooth filling (80%) whose contracted rate is $200, you’ll have to pay $40 out of pocket ($200 X (1 – .80)).
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.
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.
Another benefit is that you have more flexibility when it comes to choosing what type of plan you want. When you work for an employer, they choose which plan they believe would be right for the majority of their workers. But you might not need the same type of coverage as the person who works in the cubicle next to you. By buying an individual plan, you're able to customize and purchase exactly what you need. For that reason, your coverage can actually be less expensive than if you had an employer-sponsored plan – especially if you had to pay for part of your premiums.
One example of a Humana insurance plan is their Dental Loyalty Plus package that has a one time deductible of $150 per person or $450 for family. Unlike other plans where the deductible must be paid annually, their deductible lasts as long as you keep the plan. The maximum benefits of the plan in the first year are $1,000, in the second year are $1,250, and in the third year are $1,500. Preventative services are covered at 100%, basic services start with coverage at 40%, but coverage goes up to 70% by the third year, and major services start at 20% coverage and go up to 50% coverage by the third year.
DentalPlans.com isn’t an insurance company, but they work with dental service providers to reduce the cost to see an out-of-network dentists. In this way the company gives access to some of the same dental benefits offered by employers through typical group insurance, but more closely resembles a prescription discount card. For example, the estimate we received for a 6-month checkup was only $15. The annual cost for the plans range from $100 – $175 depending on the location and number of people covered.
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.
“Humana” is the brand name for plans, products, and services provided by one or more of the subsidiaries and affiliate companies of Humana Inc. (“Humana Entities”). Plans, products, and services are solely and only provided by one or more Humana Entities specified on the plan, product, or service contract, not Humana Inc. Not all plans, products, and services are available in each state.