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.
For the most part, Medicare does not cover dental services with the exception of those services that are required due to another covered medical issue. There are exceptions but seniors should not expect Medicare to cover routine dental care or services such as cleaning, extractions, dentures, or even fillings. If you have an alternative insurance to Medicare B then that policy might cover dental, but again, that only works in certain circumstances, such as if you are not yet retired even though you are age 62 or older.
Different companies provide various percentages of coverage in these areas. For example, one insurance provider might cover 100% of the cost of Class I services while another might only cover 80%. Yet another plan might not provide Class IV or orthodontic coverage, but provide coverage in all other areas. It’s important that you understand what services are covered before signing up for a plan.
Often, there is no waiting period in a group plan, like one offered by an employer. Of course, if you were eligible for a company-based plan, you probably wouldn't be shopping around on your own. However, the same privilege might be had in a group plan offered through an organization such as AARP. With their plans, there's no waiting period for preventative services, at least.
In order to save the most with your Humana plan, you'll have to use a dentist in their network, although they do offer you the ability to use dentists outside their network if you’re willing to pay higher fees. If you want to see a specialist, you will need to get a referral from your primary care dentist. They also offer dental savings plans which are dental discount plans rather than insurance. These plans provide discounts on your dental procedures of up to 45%.
There can sometimes be significant differences between the dental insurance plans that employers sponsor and those that you obtain as an individual. One big (and obvious) difference is that usually employers pay for part or all of the dental insurance plan, whereas if you're buying a plan by yourself you have to pay for the whole thing. Some employers are also able to get a better deal because they're buying insurance in in bulk for all their employees. But, if you shop around, you could potentially get a plan that is similarly priced or even cheaper.
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