Most independent dental insurance plans will only pay for your dental services if you go to a contracted and participating in-network dentist. Find out if you are required to go to a participating dentist or if you can choose your own. If the plan requires that you see an In-Network Dentist, ask for a list of the dentists in your area with whom they are contracted so you can decide if they have a dentist you would consider seeing.
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.
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).
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.
Guardian has dental plans for seniors that cover 100 percent of preventive services including cleanings, exams and X-rays. The only downside is it is not available in every state. For those states that are covered, seniors can obtain dental insurance that covers 100 percent of preventive services and up to 90 percent of other basic procedures such as simple extractions and fillings. Individual plans directly provided by Guardian are available to individuals living in Arizona, California, Colorado, Nevada and Utah with access through the healthcare exchange for residents of Florida, Texas, Illinois and New York.
Senior citizens across the U.S. are seeking coverage to aid in reducing their dental expenditures. Teeth, like bones, can soften as time passes and grow significantly more susceptible to degeneration and breakage. This can mean that seniors are often in need of more oral care than younger Americans, as they deal with broken teeth, loosened implants, gum problems, or other issues.
Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., and Cigna HealthCare of North Carolina, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see a listing of the legal entities that insure or administer group HMO, dental HMO, and other products or services in your state). Group Universal Life (GUL) insurance plans are insured by CGLIC. Life (other than GUL), accident, critical illness, hospital indemnity, and disability plans are insured or administered by Life Insurance Company of North America, except in NY, where insured plans are offered by Cigna Life Insurance Company of New York (New York, NY). All insurance policies and group benefit plans contain exclusions and limitations. For availability, costs and complete details of coverage, contact a licensed agent or Cigna sales representative. This website is not intended for residents of New Mexico.