Before deciding to purchase dental insurance, talk with your dentist regarding the extent of your treatment plan. This way you can decide if you would be better off with or without dental insurance. A very important factor to remember regarding any dental insurance plan is that dental insurance is not at all similar to medical insurance. The majority of dental insurance plans are designed with the purpose of only covering the basic dental care around $1,000 to $1,500 (about the same amount that they covered 30 years ago) per year and is not intended to provide comprehensive coverage like that of medical insurance.
More sensitive teeth. Your teeth can become more and more sensitive as you age due to the natural gum receding process. As your gums recede, they expose sensitive areas of your teeth that aren’t protected by enamel. Extreme temperatures may cause more pain and discomfort in these areas. Using toothpaste designed for sensitive teeth should help. If your sensitive teeth continue to be a problem, you should visit your dentist, as your problem may be more serious.
The Dental Care Cost Estimator provides an estimate and does not guarantee the exact fees for dental procedures, what services your dental benefits plan will cover, or your out-of-pocket costs. Estimates should not be construed as financial or medical advice. For more detailed information on your actual dental care costs, please consult your dentist or your Delta Dental.
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Finding dental insurance for seniors doesn’t need to be an ordeal. Our customized senior dental insurance plans offer a variety of options designed specifically for the unique dental needs of seniors. And with additional savings and discounts, including EyeMed Discount Vision and Connection Hearing, your benefits are comprehensive and affordable. Our senior plans start at as low as $33 a month.
Dental insurance companies divide benefits, services, or procedures into categories and refer to them with American Dental Association (ADA) 3-4 digit code. As an example, Preventative and Diagnostic procedures often include exams (ADA code 0120), x-rays (ADA code 0210), and basic cleanings or prophylaxis (ADA code 1110). Basic procedures often include fillings, periodontics, endodontics, and oral surgery. Major procedures often are crowns, dentures, and implants. Procedures such as periodontics, endodontics, and oral surgery may be considered major, depending on the policy.
Unfortunately, Original Medicare (Parts A and B) does not include coverage for services like dental exams, cleanings, fillings, crowns, bridges, plates, or dentures. There are some exceptions, such as when a hospital stay is involved, but otherwise, you would have to pay out of pocket for any routine dental services. For some of us, those expenses could add up quickly.

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).
Delta Dental PPO Value for Seniors has nationwide coverage, but may only be purchased for seniors whose primary residence is in Massachusetts.  Delta Dental of Massachusetts PPO insurance products are offered by Dental Service of Massachusetts, Inc.  An Independent Licensee of the Delta Dental Plans Association. ®Registered Marks of the Delta Dental Plans Association. ©2016 DSM. 
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.
All dental insurance plans or dental savings plans will charge a different monthly premium. These will vary depending on the number of individuals that you're enrolling in the plan, the type of plan you’re applying for, and the level of coverage you need. Most affordable dental insurance plans will charge you different prices for individuals and children and then, after a certain number of individuals, they just charge a flat family fee.
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.
The Dental Care Cost Estimator provides an estimate and does not guarantee the exact fees for dental procedures, what services your dental benefits plan will cover, or your out-of-pocket costs. Estimates should not be construed as financial or medical advice. For more detailed information on your actual dental care costs, please consult your dentist or your Delta Dental.
As a Medicare beneficiary, you are free to shop for a stand-alone private dental plan for seniors. Some dental plan types are PPO plans* and others are indemnity plans. A PPO stands for preferred provider organization. This is a type of plan that contracts with dental providers to create a network of participating providers. If you want to use a dentist out of network, you usually can for an additional cost. An indemnity plan allows you to visit almost any dentist you like with the plan paying a portion of your total charges. Indemnity plans are also called “fee-for-service” plans.
How you define “cost” is important. Generally a single plate – upper or lower- costs between $1,200 and $3,800. So, for a full set of dentures could cost in the $7,500 range. Those higher costs usually include other services such as extractions, mold production, and fittings. Again, the actual cost is dependent upon the senior’s oral health, and the amount of service needed. Don’t be afraid to shop around from one dentist to the next to see if there is a price break.
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.
DHMO's are similar to HMOs in that their plans connect you with a network of dentists who give you care for a low monthly premium. With DHMO plans, you are required to go see dentists who are in their network, but in return you have lower costs, and no claim forms to fill out. DHMOs are great for preventative care and basic procedures. Some downsides include that there can be wait times if you need major or restorative dental care and some DHMOs don’t cover this types of treatment. You also need to go see your primary care dentist and get a referral to a specialist in order to get some specialized care.
When you near the age of 65, you need to sign up for Medicare. However, Medicare does not cover preventative dental care or other procedures such as fillings, tooth extractions, dentures or other dental devices. If you have a complicated or emergency dental procedure that requires hospitalization, Medicare Part A will likely cover the cost, but it is obviously preferable to avoid hospitalization if you can with regularly-scheduled dental care.
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.
The term “full coverage” can mean different things to different people. For some, “full coverage” means a dental insurance plan that covers basic services like routine checkups, cleaning and X-rays. Others expect a full-coverage plan to reduce the cost of any dental services they may need. The good news is that Humana has a range of dental plans, including both dental insurance and dental discount plans, so you can find the coverage that best fits your needs.
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