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.
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.
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.
Choosing a plan that’s right for you depends on many factors, including the ages and number of people in your family, and whether you or a family member needs orthodontic care. Some dental plans provide low copays, while others provide discounts on services. No matter which plan you select, you’ll have access to a large network of dental providers.
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.
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.