PPO Plan A is the most comprehensive plan with the highest number of services covered and still has a modest premium. PPO Plan A covers three cleanings and exams per year at no additional cost when visiting an in-network provider. There are no exclusions for most pre-existing conditions and dental implants are available after 1 year of continuous coverage. The annual deductible is $50 with an annual maximum of $1,500. You are allowed to visit any licensed dentist but with save money through using a preferred in-network provider.
In general the dental insurance companies at the top of our review list provide a range of plan options to numerous areas of the country. We also considered average yearly preventive care costs across numerous zip codes and compared that number to possible yearly premium costs. This helps predict whether the premium costs would, on average, be less than the cost of preventive care paid out of pocket. Keep in mind that co-pays and other small fees might also determine whether you will break even by paying for dental insurance, but our numbers can give you a general idea of what you can expect. It was not surprising to learn that those who charge a higher premium may cover more and those with a lower premium might cover less. This means that if you pay more monthly you might receive more complete coverage, and if you pay less per month you might be expected to pay a bit more during the time of treatment. So you'll need to decide whether you want to pay more per month or make up a bit of the difference when you visit your dentist.
As time passes, many seniors leave dental coverage (and vision and hearing) behind. Then, when they need it, it is too late. Waiting can be devastating in some cases as many insurances have waiting periods for certain services. For example, a routine filling for a cavity typically requires a 6-month wait. If you can’t wait that long, you will have to pay the cost in full.
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.
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.
A carrier recently told us that many seniors expect to carry over their dental coverage from their employer. Yet, that rarely happens. What does happen is that about 90% of seniors on Medicare don’t have proper dental coverage (American Dental Association). After filling out the Medicare paperwork, most seniors put dental insurance on the back burner. (And vision and hearing, too…we’ll get to those later.) And, why not? Your teeth are not hurting yet and they feel pretty good.
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.
Our health benefit plans, dental plans, vision plans, life and supplemental plans, workplace voluntary benefit products, long term disability plans, and short term disability plans have exclusions, limitations, and terms under which the coverage may be continued in force or discontinued. Our dental plans, vision plans, life and supplemental plans, workplace voluntary benefit products, long term disability plans, and short term disability plans may also have waiting periods. For costs and complete details of coverage, call or write Humana or your Humana insurance agent or broker.
We have multiple plans with different levels of benefits to help you find the best dental insurance fit for your budget.3 So if you’ve ever bought a gym membership or a treadmill to help remind you to take care of yourself, supplemental dental insurance from UnitedHealthcare can be that reminder to take care of your teeth. Even better, it can help you plan, control and budget for the costs of your dental care.