Humana individual dental plans are insured or offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, The Dental Concern, Inc., CompBenefits Insurance Company, CompBenefits Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc., Humana Health Benefit Plan of Louisiana, Inc., or DentiCare, Inc. (DBA CompBenefits). Discount plans are offered by HumanaDental Insurance Company, Humana Insurance Company, or Texas Dental Plans, Inc. Arizona residents insured by Humana Insurance Company. Texas residents insured or offered by Humana Insurance Company, HumanaDental Insurance Company, or DentiCare, Inc. (DBA CompBenefits).
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 of the biggest downsides of paying for your own plan is that your premiums might not be pre-tax as they would be if you were paying for a plan that your employer and your contribution towards the plan was being taken off your paycheck. But, if you own your own business, you can potentially write off those expenses as a business cost and therefore get the same savings.
They have a popular dental PPO plan called MetLife 2-9 Dental. They negotiate fees within their network of dentist which are lower than average and cover over 400 procedures. They offer 100% coverage on preventative care, 80% coverage on basic care, and 50% coverage on major care with a $50 deductible. Their annual maximum coverage amount is between $1,000 and $1,500.
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).
Aetna’s dental discount network includes over 161,000 dentists, and Careington says over 100,000 dentists participate in their plan. We searched for providers from a less populated location in the U.S. and found no dentists from the Aetna plan while the Careington plan had four dentists, although the offices were located 100 miles from the zip we used. If there are no providers available in a reasonable distance from your home, you can nominate dentists, and Careington will contact them to request participation. Dental providers usually join the network within 60-90 days.
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.
While we conducted extensive research, we cannot tell you exactly what your new dental plan premium will be or what it will cover. Premiums vary by zip code, age, plan type and other factors. Our reviews can tell you generally what to expect from the dental insurance companies we reviewed, but we cannot predict your exact situation. To calculate average premiums we gathered quotes from numerous areas across the nation; we chose zip codes from large metropolitan areas and from smaller cities of around 150K. We looked for premium rates for one, two and three persons. We made note of the lowest and highest premiums quoted and excluded dental discount plans and preventive-only plans. The sample terms and conditions are common scenarios, but again, these vary depending on the plans available in your area.
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.
If you don’t floss or brush every day, you will likely run into dental problems that everyone is susceptible to, including cavities, gum disease, tooth decay, and enamel erosion. However, there are some dental issues seniors are more at risk for than any other group of people. Seniors can develop these problems even if they properly take care of their teeth.
There are many insurance companies that offer dental services to seniors. Many are part of the group of insurance companies that fall under Medicare part C. While every insurance company under Medicare Part C offers the same medical coverage as Medicare Part A and Part B, they sometimes offer additional services such as dental coverage. Even so, the types of dental coverages that they offer are not identical.
Another thing to consider when looking for dental plans for seniors is the waiting period some plans may have for certain services. For example, a plan may set a 3-month waiting period for an extraction. This means that if you get an extraction a week after enrolling in that plan, you usually won’t be covered. Some services may have longer waiting periods, such as 15 months, before the plan covers that service. This is why it is best to not wait until you have a dental emergency to enroll in a dental insurance plan.
Maintaining oral health can be more challenging for seniors and people with certain disabilities. This may be due to an inability to brush their teeth properly, as well as an increased use of medications. Plus, as we grow older, our teeth become less sensitive, so we may not notice a problem until it is too late. All of these factors make it even more important to protect your dental health as you age.1
While some financial planners suggest dental insurance may not be worth paying for, we did the math to discover that it is usually worth it, provided you attend all of your allowable preventive exams and cleanings. We also learned that if you need any type of work such as a root canal or filling, you will definitely notice a cost savings. However, premiums vary greatly, not only by the type of plan, but by location and age. So you'll want to obtain a few quotes for insurance companies that provide coverage in your area. You'll also want to verify that your dentist accepts your chosen insurance before you sign up with a new provider.
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.
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.
In addition to companies listed here, you can check out other options by using a dental insurance search engine, such as the one available at the Dental Insurance Store. There you can plug in your age and ZIP code and get a list of plans available in your area. Along the left side of the screen, you can select various options that may be important to you – such as “no waiting period.”
PPO Plan B has slightly lower premiums and still covers many basic services. The annual deductible is $100 with an annual maximum of $1,000. Keep in mind you are trading in the lower deductible for a higher one but you are also receiving a lower monthly premium. You have 80 percent coverage for three dental cleanings and exams per year and coverage is available for major services including implants, crows, bridges and dentures after one year of continuous coverage. You can visit any licensed dentist but save more by choosing a preferred in-network provider.
DentalPlans.com provides dental coverage to more than 1 million customers across all 50 states. DentalPlans.com has an extensive network including more than 100,000 dentists across the country. Although DentalPlans.com is not an insurance company they work to reduce the cost of dental repairs, as well as covering those who may need to visit an out-of-network dentist.
Although discount plans are also sold by private companies, they are not insurance plans. There are no copays, coinsurance, or deductible amounts. That also means that there are no pre-negotiated rates or free yearly checkups and cleanings. A participating dentist simply agrees to offer discounts (often a percentage off from the total price) for certain medical services. Then, seniors who choose discount plans will pay their dentist directly for the cost of services (after the discount).
Your Current Dental Health – Do you have pending dental needs, such as needing dentures, extractions, crown replacement, etc? This is all about the state of your mouth, teeth, and oral tissue today and for the next six months. That time frame is important because many dental insurance policies have a waiting period before you can use their benefits. For most, that period is six months.
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.
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We hoped you learned more about dental insurance for seniors. You have many affordable options. Need assistance or want to learn more? Feel free to contact us or use the form below. We would be happy to help you find an affordable insurance plan for you. Remember, we work in your best interests only. This is the only way we know how to work with our clients. If there is a better plan available that we can’t offer you, we would be happy to help you obtain or recommend that plan to you.
To begin using the Dental Care Cost Estimator tool, click the Agree button below. By clicking, you agree that you have read the information below, are accessing this information for purposes of determining treatment cost estimates for dental care services you are considering receiving, and will not use the information in this tool for a commercial or anti-competitive purpose. The costs provided in this tool are estimates only and are not a guarantee of payment or benefits. Your actual cost may be higher or lower than the estimate for various reasons.
If you're wondering if the Affordable Care Act of 2014, also known as Obamacare, affects dental coverage – it does. You can buy health coverage through the online health insurance marketplace that includes dental coverage. You can also purchase a standalone dental insurance plan through the health insurance marketplace, but in order to do so you have to also purchase a standalone health plan through the marketplace.
Dental savings plans are different than dental insurance. Dental savings plans provide you with a list of dentists who will give you a discount because you’re a member of the savings plan. Usually, these are quite generous discounts and can save you a significant amount of money on your dental care. Sometimes the discount can be well over 50% for things like preventative care, but it tends to be a little less for other types of care.
Some of the benefits of a Carrington dental plan are the low fees, the fact there is no waiting, and that you can choose your own dentist amongst their network. There are also no limits on your coverage and you don't have to fill out any paperwork. Some downsides are that you will likely end up paying more for your procedures than if you had one of the best dental insurance plans.
Fee-for-Service plans: Like DPPO plans, dental Fee-for-Service plans require you to pay a percentage of the cost of treatment. Your insurance company will pay for the rest. Fee-for-Service plans typically offer the most freedom when it comes to choosing your dentist or dental practice. Fee-for-Service plans may also be more costly, since dentists are not typically reimbursed at the same rate as DPPO dentists.
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.
However, if you do have existing dental issues that require major dental work, then it would be best to find a dental plan without any waiting periods for major services. Fortunately there are a number of plans that fall into this category and allow a growing level of coverage for all services that can begin immediately. At EasyDentalQuotes, some of these plans include the Delta Dental Immediate Coverage plan and plans with Renaissance Dental.
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.
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.
Nothing on this website guarantees eligibility, coverage, or payment, or determines or guarantees the benefits, limitations or exclusions of your coverage. For a complete description of the details of your coverage, please refer to your coverage documents. Estimates may vary depending on your benefit plan and the state you live in. Claims will be processed when received according to your plan provisions.
Most Medicare or Medicare Advantage Plans provide no dental coverage or only provide minimal dental coverage. Those that do provide coverage, usually only cover preventive services so many seniors find the need to buy a dental insurance policy. Some top considerations for seniors purchasing a dental insurance plan include in-network providers, types of services covered, deductibles and co-pays. We done some comparisons and come up with some of the best dental insurance options for seniors in 2018.
Estimating your possible dental costs may help you decide whether dental insurance would be financially beneficial. Dental insurance companies will show you a quote online so you can easily see what your premiums might be. You may want to compare your estimated yearly premiums to the cost of a year of procedures you want to have done. You can estimate how much your dental expenses might be either by talking with your dentist, or by researching costs online. You can use the estimates to help you decide whether you should pay out of pocket or plan your dental expenses based on your insurance coverage. Two resources for looking up procedure costs are The Fair Health Consumer Organization and the Guardian Insurance website. Estimated costs are sorted by zip code and will show a low and high rate so you can see a range of what a procedure may cost in your area.