DentalPlans.com is one of the leading online marketplaces for finding dental savings plans. The company has been in business since 1999 and is affiliated with more than 30 dental plan companies and has over 100,000 participating dentists around the country. The benefit of using DentalPlans.com is it allows you to access the number of different dental plans to find out which is the best deal for you.

Generally dental offices have a fee schedule, or a list of prices for the dental services or procedures they offer. Dental insurance companies have similar fee schedules which is generally based on Usual and Customary dental services, an average of fees in an area. The fee schedule is commonly used as the transactional instrument between the insurance company, dental office and/or dentist, and the consumer.
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.
Dental Preferred Provider Organization (DPPO) plans: DPPO plans offer you more choice when it comes to dentists. PPO networks include a variety of dentists that agree to treat patients with DPPO insurance at lower rates. Typically, patients with DPPO have to pay a deductible. When seeing a dentist in your DPPO network, you will usually pay a percentage of the lower rate for treatment. Your insurance company will pay for the rest.

Medicare Health Plans is more than just Medicare plans! We work with seniors for all of their insurance needs. One of the most common types of insurance that seniors ask about is dental insurance. Since routine dental care is not included in Medicare and the “gateway” to your body is too important to ignore, seniors want dental insurance options. We represent multiple carriers and plans and believe we have the plans that will best fit your needs.

Gum Disease. Your gum disease risk increases as you get older. The New York Times notes that in a study of people over 70 years old, 86% had at least moderate gum disease and over a quarter experienced tooth loss. It’s important to properly take care of your teeth, have a healthy diet, reduce stress, and refrain from smoking to reduce your risk of developing gum disease. Systemic diseases and certain medications can also affect the health of your gums.

The next thing that you need to look at is the yearly enrollment fee that you will be charged. This fee can vary widely between insurers. For example, Humana only charges an enrollment fee when you first enroll and not in any year afterwards. Other insurers will charge you an enrollment fee every year. These fees are generally under $50 per year, so if you find an insurer that is charging you more make sure that it’s worth it to you because you’re saving on the plan elsewhere.
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).

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.
The final kind of dental insurance is indemnity dental coverage. These plans allow you to visit any dentist and they will pay a fee for the procedures you have done. They calculate a set amount that they’ll pay for each type of procedure and any additional amount would have to be paid by you out-of-pocket. They also have an annual maximum which can sometimes be higher than other types of plans. One of the downsides is that you have to pay for all the services upfront and submit paperwork in order to get reimbursed.

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.
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Medicare Advantage plans may offer routine dental care. Medicare Advantage is another way to get you Original Medicare (Part A and Part B) benefits from a private insurance company. A Medicare Advantage plan may offer routine vision as well as prescription drug coverage. If you have a Medicare Advantage plan you have to continue paying your Part B premium. Medicare Advantage plans must cover everything that Original Medicare covers except for hospice care which is still covered by Medicare Part A. The extent of the Medicare Advantage dental coverage may vary from plan to plan.

3In WY, you don’t need to select a primary care dentist, but you must visit a DeltaCare USA dentist to receive benefits. In the following states, you can maximize your savings when you visit a DeltaCare USA dentist, although you may visit any licensed dentist and receive out-of-network coverage: AK, CT, LA, ME, MS, MT, NC, ND, NH, OK, SD, VT. Refer to your Policy for details about your out-of-network benefits.
Most people know that they need to visit a dentist regularly. Having dental coverage is strongly associated with how often dental services are used. Americans often say that the cost of dental care and the lack of dental coverage are reasons for not getting needed dental care. Having an individual dental insurance plan from Spirit Dental allows you to get the regular care you need to stay healthy.
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