Spirit Dental is the online storefront for Direct Benefits, a company started in 2001 by Tom Mayer, who wanted dental coverage to be affordable for all Americans. While Direct Benefits serves as a broker for employee benefits and consultants, Spirit Dental is meant for online consumers who can buy coverage right on the website or talk to one of their many agents and providers nationwide.
They provide discounts on your claims that average around 20.3% in addition to covering a percentage of your costs. Delta Dental Premier works with a network of dentist that offer lower costs on their services which equates to cheaper treatments for you. Dentist in this network are not allowed to bill you additionally after you pay your agreed co-payment or deductible.
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Generally Original Medicare dental coverage is only for limited circumstances involving hospitalization. Original Medicare (Part A and Part B) generally doesn’t cover most dental care, including cleanings, fillings, tooth extractions, dentures, and dental plates. Hospital insurance (Part A) may pay for emergency or complicated dental procedures, for example the reconstruction of the jaw following an accidental injury, according to the Centers for Medicare & Medicaid services (CMS). According to CMS, Congress has not amended the dental exclusion since 1980, when it made an exception for inpatient hospital services when the dental procedure itself made the hospitalization necessary. If you have Original Medicare and want routine dental care, you will generally need to find a plan from a private insurance company.
Dental insurance almost always picks up 100 percent of the bill for routine checkups and cleanings. Coverage for common procedures like root canals and fillings are typically covered at 80 percent, although policies with higher premiums cover up to 90 percent. You are then responsible for the remaining 10 to 20 percent of the cost, called coinsurance. Most plans cover higher-priced and more involved procedures at 50 percent, so you should have some savings set aside for what your insurance does not cover. Still, with relatively low premiums, having dental insurance is far less expensive on average than paying cash for all dental procedures.
Humana has a loyalty rewards dental program which increases coverage over time, making it an attractive choice for seniors seeking dental coverage. Plans, coverage options and premium vary by state. Another great option for seniors is the ability to purchase vision insurance in combination with the Humana dental plan. If you purchase both individual dental and
Since this is an indemnity plan, you can use other insurances or coverage. A dental discount plan can work well here. Using the above example, if the dentist routinely charges $200 for cleaning, but per the discount plan contract, charges you $100, you will have a net cost of $10. Remember, most discount dental plans charge between $8 and $15 per month depending on other features.
After you are approved and sign up for a plan, you can often use it within 24 hours, but it can sometimes take up to 72 hours for it to go into effect. Some plans offer additional savings on things like prescriptions, hearing care, and vision care. Some plans also include discounts on things like cosmetic dentistry, and orthodontics. These plans charge an affordable membership fee that can start as low as $10 per month. In order to get set up, you do have to pay a fee of around $15, but this cost is sometimes offset by giving you a free month on your plan.
Humana individual dental plans are insured or offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, The Dental Concern, Inc., CompBenefits Insurance Company, CompBenefits Insurance Company, CompBenefits Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc., Humana Health Benefit Plan of Louisiana, Inc., or DentiCare, Inc. (DBA CompBenefits). Discount plans are offered by HumanaDental Insurance Company, Humana Insurance Company, or Texas Dental Plans, Inc. For Arizona residents: Insured by Humana Insurance Company. For Texas residents: Insured or offered by Humana Insurance Company, HumanaDental Insurance Company, or DentiCare, Inc. (DBA CompBenefits).
We evaluated 24 dental insurance companies and found the three top choices for seniors based on the cost of premiums, the number of in-network dentists and overall cost savings. Our top three picks are DentalPlans.com, Spirit Dental and 1Dental.com. In this guide, we will discuss what you need to look for in dental insurance, why seniors need dental insurance and we’ll share details about the top companies. We included helpful frequently asked questions about dental insurance as well.
Once you purchase a dental insurance plan and start paying your premiums, most preventive care like cleanings and check-ups are covered immediately. For more serious procedures, after you meet your deductible, you’ll only be responsible to pay your percentage of the cost. And we’ll pay the rest. Also, some dental plans have an out-of-pocket maximum to protect you from high costs throughout the year. On some plans, if you reach this maximum, we’ll pay the full cost of any additional care until your annual maximum benefit is met. 
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.
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However, if your insurance does not cover cleaning and preventative care at 100%, then you will have to pay the remaining costs of your visit. This can cost anywhere from $20 to over $100 depending on the type of care you’re getting and the percentage covered. If you’re getting a PHMO plan, it is easier to estimate your costs since all procedures conducted in their network will have fees, but if you’re going to your own dentist then it will simply be a percentage of whatever they charge.
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.
I could have paid the average of $360 a year for a dental policy in my twenties. Or I could have paid out of pocket for two dental exams, including cleanings and X-rays, which, in 2011, cost an average of $370 combined. In that case dental insurance wouldn’t have saved me much money. And if I went to a dental school or clinic for treatment, I could have saved even more on out-of-pocket costs.
« BackeHealth Insurance Resource CenterDental InsuranceDental Insurance for SeniorsDental Insurance for Seniors April 20, 2015 Learn about dental care concerns later in life, and dental insurance for seniors. ShareSenior citizens sometimes need special dental care. As we age, our teeth and gums are more susceptible to decay, inflammation, and disease. Health problems, like osteoporosis, diabetes, heart disease, stroke, and respiratory disease can also affect dental health, and sometimes the reverse is true, according to the Columbia University College of Dental Medicine and the American Dental Association.Why to consider dental insurance for seniorsOut of all out-of-pocket health-care costs, 27% of expenses are related to dental services, according to the Robert Wood Johnson Foundation; some people delay needed dental care because of the expense.Dental insurance isn’t usually included in major medical insurance policies, such as you may have from your employer. You can buy a stand-alone dental plan to cover some of your dental care costs.Keep in mind that dental insurance often requires a waiting period for more expensive treatments, so it’s best not to wait until you need dental insurance to get it.Standard dental policiesYou can buy a standard individual dental insurance plan, usually at a low monthly premium. Standard policies commonly cover these routine procedures, typically performed by family dentists:Regular cleanings and exams: Most policies entitle you to a free cleaning and comprehensive exam twice a year.X-rays: Dentists periodically take bitewing X-rays of your teeth. Depending on your dental insurance plan, x-rays may be fully covered, or you might make a copayment. Other X-rays of your mouth may require a copayment, coinsurance, or deductible.Fillings and extractions: Fillings (removal of decay and filling with a bonding material) and extractions (pulling a tooth out of your mouth) usually require a copayment, coinsurance or deductible in most dental insurance plans.Certain repairs: Standard individual dental insurance plans occasionally include partial coverage on some restorative procedures, such as root canals, crowns, bridges, and deep cleanings. Dental insurance plans usually require a copayment, coinsurance or deductible for these procedures, if they cover them. However, you might need to shop around for a policy that covers these more expensive services.  wp_cta_load_variation( '10789', '' )#cta_container{ border: 1px solid #dbdbdb; border-radius: 5px; } #wp_cta_10789_variation_0 #cta_container #content {background: transparent;}
*Out-of-network/non-contracted providers are under no obligation to treat Preferred Provider Organization (PPO) plan members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
If you don’t floss or brush every day, you will likely run into dental problems that everyone is susceptible to, including cavities, gum disease, tooth decay, and enamel erosion. However, there are some dental issues seniors are more at risk for than any other group of people. Seniors can develop these problems even if they properly take care of their teeth.
AARP and its affiliates are not insurers. AARP does not employ or endorse agents, producers or brokers. AARP Member Advantages is the name for a collection of products, services and insurance programs available to AARP members from trusted third parties. AARP member benefits, including all goods, services and discounts on this site, are provided by third parties, not by AARP and its affiliates. Providers pay a royalty fee to AARP for the use of its intellectual property. These fees are used for the general purposes of AARP. Provider offers are subject to change and may have restrictions. Please contact the provider directly for details.
In either case, in our opinion, the purchase of dental insurance can be hard if you don’t do your homework. Why? The premiums aren’t in favor of the benefit. For example, if you are paying $100 per month for dental insurance which has an annual benefit of $1,000, that really isn’t in your best interest. You are paying $1,200 annually for a $1,000 benefit. In this case, it is better to simply negotiate a discount with the dentist or utilize a dental discount plan where appropriate (more on that below).
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.
Estimating your possible dental costs may help you decide whether dental insurance would be financially beneficial. Dental insurance companies will show you a quote online so you can easily see what your premiums might be. You may want to compare your estimated yearly premiums to the cost of a year of procedures you want to have done. You can estimate how much your dental expenses might be either by talking with your dentist, or by researching costs online. You can use the estimates to help you decide whether you should pay out of pocket or plan your dental expenses based on your insurance coverage. Two resources for looking up procedure costs are The Fair Health Consumer Organization and the Guardian Insurance website. Estimated costs are sorted by zip code and will show a low and high rate so you can see a range of what a procedure may cost in your area.
We evaluated 24 dental insurance companies and found the three top choices for seniors based on the cost of premiums, the number of in-network dentists and overall cost savings. Our top three picks are DentalPlans.com, Spirit Dental and 1Dental.com. In this guide, we will discuss what you need to look for in dental insurance, why seniors need dental insurance and we’ll share details about the top companies. We included helpful frequently asked questions about dental insurance as well.
No matter which type of plan you choose, we recommend that you carefully review your contract so you know exactly what your insurance will cover. Additionally, in most cases your dentist's office will be familiar with what your insurance may or may not cover. Since many dental offices will require you to pay the estimated uncovered balance upfront, you will need to make sure you know what that is in advance so you can plan your budget. If you cannot cover the remaining balance you may want to ask if your dentist provides financing.
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.
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