The longer you stay with Spirit Dental, more each plan pays out and the higher your savings. For example, with one plan’s basic dental procedures are covered at 65 percent the first year, 80 percent the second year and 90 percent the third year. Major procedures on that plan follow the same timeline at 25 to 65 percent coverage. All plans cover preventative care at 100 percent. You can bundle EyeMed vision insurance for $7 per month with each plan.
Most dental insurance companies have a waiting period after your application is accepted. This practice is so the customer doesn’t wait until they have accumulated the need for several procedures to buy and use dental insurance to cover the costs. Most plans have a waiting period for some procedures but not others, like a regular checkup. One of our best dental insurance companies has no waiting period for just about any procedure.
Medicare recipients are legally permitted to purchase dental plans on the ACA Marketplace, but the process isn’t easy. As noted in the section above, stand-alone dental plans are not eligible for subsidies. And in the states where the ACA Marketplace is run by the federal government, dental coverage is available only to those who also buy health insurance.
Other factors can affect your yearly dental expenses as well. Unfortunately, senior premiums are usually more and youth orthodontics may also cost more. Smokers are usually quoted higher premiums as well. Monthly premium rates vary greatly by region and area. We found that within the same insurance company rates may vary by as much as 30 percent depending on the zip code.
The downside of using a dental school is that it can sometimes take a lot more time to get the work done since it’s a learning environment, the hours or days that they practice are limited, and it can be hard to get your insurance coverage to pay for work performed at a dental school if you have insurance. You’ll likely have to pay for your treatment out-of-pocket and get reimbursed later.
Another option for dental care is Medicaid, which covers some kinds of dental procedures if you meet the requirements. Medicare does not provide dental coverage. The ADA Foundation has provided dental care to 5.5 million children since 2003. They will direct you to a dentist that is near you. Another option is the Children Health Insurance Program (CHIP). It provides health coverage including dental coverage to over 7 million children under 19 years of age.
Like most kinds of health or ancillary medical insurance, there are deductibles involved in dental insurance. Generally, the deductibles are per individual or per family depending on your plan. Some companies require that you meet the deductible on each member of your family while others have a family amount that you have to hit – no matter who the person receiving the care was. Deductibles can range anywhere from $100 to $500 or more. Obviously, the higher your deductible, the less likely you’ll be to take full advantage of your insurance.
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.
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.
*Examples only. These are the average costs the patient will pay per procedure with an in-network provider and are based on averages across Atlanta, Cincinnati, Los Angeles, Manhattan and Saint Louis. Actual costs and savings may vary by provider, geographic area, and service received. There are limitations and exclusions to the discount available. For example, general anesthesia, implants, and/or cosmetic dentistry are not discounted services. Upon purchase, refer to your policy for more information on the limitations and exclusions that apply. Coinsurance listed is for Prime Plan C.
If you read our article on discount dental plans, you may think we are 100% against dental insurance. We are not. We simply know seniors can get sucked into paying high premiums with equally high out-of-pocket costs with no major insurance advantage. But, affordable dental insurance for seniors is possible that balances the right premiums, out-of-pocket costs, and coverage.
If you're struggling to find an affordable dental insurance, your state might offer some programs that could help you. Many states have assistance programs for those who are unable to pay for dental care themselves. To find out whether your state has a program, visit the National Association of Dental and Cranialfacial Research, as well as the Association of State and Territorial Dental Directors. Their websites have links and information about how to get low-cost dental care in your state.
After you are approved and sign up for a plan, you can often use it within 24 hours, but it can sometimes take up to 72 hours for it to go into effect. Some plans offer additional savings on things like prescriptions, hearing care, and vision care. Some plans also include discounts on things like cosmetic dentistry, and orthodontics. These plans charge an affordable membership fee that can start as low as $10 per month. In order to get set up, you do have to pay a fee of around $15, but this cost is sometimes offset by giving you a free month on your plan.
Our health benefit plans, dental plans, vision plans, and life insurance plans have exclusions, limitations, and terms under which the coverage may be continued in force or discontinued. Our dental plans, vision plans, and life insurance plans may also have waiting periods. For costs and complete details of coverage, call or write Humana or your Humana insurance agent or broker.