*Out-of-network/non-contracted providers are under no obligation to treat Preferred Provider Organization (PPO) plan members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
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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.
In the United States, Participating Provider Network or PPO, also referred to as Preferred Provider Organization, is an organization governed by medical doctors, hospitals, other health centers, and medical care providers. This organization has an agreement with an insurer or the third party administrator to provide health insurance to the people associated with their client at reduced or low rates. Participating Provider Network plan may work similar to a DHMO while using an In-Network facility. However, a PPO allows Out-of-Network or Non-Participating Providers to be used for service. Any difference of fees will become the financial responsibility of the patient, unless otherwise specified.
You may have a preexisting oral health condition that is not covered by your current dental policy. Because discount plans are not insurance, they have no waiting periods. You can sign up today and be at the dentist in 30 minutes. If you’ve reached your annual maximum, you can use a discount plan to pay for a procedure you have been reluctant to get because of the out-of-pocket expense.
By using this website, I confirm that I understand and agree to the applicable Privacy Policy and Terms of Service. I understand that by calling the phone number above I will reach a licensed sales agent. *Not connected with or endorsed by the United States government or the federal Medicare program. Medicare has neither reviewed nor endorsed this information. Copyright © 2018 Medicarehealthplans.com. All rights reserved. 5202 W. Douglas Corrigan Way, Suite 300, Salt Lake City, UT 84116. Medicarehealthplans.com is a free information source designed to help find insurance coverage. Whether you are looking for a Medicare Advantage Plan, a Prescription Drug Plan or a Medicare Supplemental plan, our licensed agent can help you find the right coverage options. We compile our data from multiple sources, which includes the government, non-profit and private sources. The rates and information displayed is for informational purposes only, and should not be construed as advise, consult, or recommendation. For specific plan details and further information, contact the carrier directly.
First, you could enroll in a Medicare Advantage plan. Many Medicare Advantage plans include vision, dental, and prescription drug coverage. All of these benefits are coordinated together, so any premium costs will be included in your low (or non-existent) Medicare Advantage premium. Just be aware that dental benefits are usually limited to cleanings, exams, and bitewing X-rays. If you are looking for more comprehensive coverage, you may want to add on a stand-alone dental plan.

A PPO, or preferred provider organization, is the most common type of dental insurance. This plan has arranged reduced rates with dentists. These dentists are called in-network because they will work with the insurance company. You can go out of network if you have a PPO plan, but you will not get the benefit of the reduced rates. It’s best to check to see if your preferred dentist is in-network before you buy insurance.
DentalPlans.com isn’t an insurance company, but they work with dental service providers to reduce the cost to see an out-of-network dentists. In this way the company gives access to some of the same dental benefits offered by employers through typical group insurance, but more closely resembles a prescription discount card. For example, the estimate we received for a 6-month checkup was only $15. The annual cost for the plans range from $100 – $175 depending on the location and number of people covered.
A PPO, or preferred provider organization, is the most common type of dental insurance. This plan has arranged reduced rates with dentists. These dentists are called in-network because they will work with the insurance company. You can go out of network if you have a PPO plan, but you will not get the benefit of the reduced rates. It’s best to check to see if your preferred dentist is in-network before you buy insurance.
Does this sound good? Maybe. You’ll pay for everything…at a discount. How does this compare to traditional dental insurance? In our opinion, you may end up paying the same or less, generally speaking. While you have to pay for preventative care, it is at a discount. Compare with dental insurance, which the preventative care is free but you generally pay a higher monthly premium.
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*The plan is insured by Delta Dental Insurance Company (Contract 1230) in AK, AL, DC, DE, FL, GA, LA, MD, MS, MT, NV, NY, PA, PR, TN, TX, UT, VI and WV, insured by Dentegra Insurance Company (Contract 1230) in AR, AZ, CA, CO, CT, HI, IA, ID, IL, IN, KS, KY, ME, MI, MN, MO, NC, ND, NE, NH, NJ, NM, OH, OK, OR, RI, SC, SD, VA, VT, WA, WI and WY, and insured by Dentegra Insurance Company of New England (Contract 1230) in MA. The plan is administered by Delta Dental Insurance Company. For Texas residents your Master Policy Form number is TX-AMD-MC-DPO-D-DC(DELTAUSA1-2005). These companies are financially responsible for their own products.
We evaluated 24 dental insurance companies and found the three top choices for seniors based on the cost of premiums, the number of in-network dentists and overall cost savings. Our top three picks are DentalPlans.com, Spirit Dental and 1Dental.com. In this guide, we will discuss what you need to look for in dental insurance, why seniors need dental insurance and we’ll share details about the top companies. We included helpful frequently asked questions about dental insurance as well.
Many provide as much as 100% coverage preventative services and then less on basic procedures usually 50% to 80%, and usually 50% to 0% on major care or things like crowns. Often there is some fine print with these plans and they do not cover certain procedures. They also have a maximum annual benefit and a deductible that you have to pay before they start coverage. There also can potentially be waiting periods on certain types of procedures but you don’t always have to get a referral to see a specialist.
Dental plans will usually cover a portion of your costs on different types of dental procedures. Some plans focus more on preventative and basic dental care, but offer less coverage on major dental procedures. It's important to understand what's best for your dental health. If you routinely need a root canal or get cavities, you'll want a plan that provides better coverage on those types of procedures. In contrast, if you have relatively healthy teeth then you might not need to pay for the extra coverage.
The Mayo Clinic advises that poor dental health significantly impacts your physical health, including causing heart disease and endocarditis, an infection of the heart’s inner lining. Diseases which often affect us as we age like osteoporosis, diabetes and rheumatoid arthritis, to name a few, frequently cause dental problems that eventually become too painful to ignore. Seniors often need more dental care than younger generations because of softening bones and teeth or a dry mouth, which can lead to an assortment of oral health problems. Regular visits to the dentist can save money down the road while reducing the risk of painful dental problems.
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.
We understand that individuals and families are looking for dental insurance solutions to fit their specific needs. Our dental insurance plans include options for any budget and tailored coverage options offering dental care choices for individuals or families. With choices for higher maximum benefit amounts with more coverage if needed, options if your child needs braces, and immediate coverage on most services, we have a dental insurance plan for you. Discover more about our dental insurance plans below:
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.
The information and content (collectively, "Content") on this website is for your general educational information only. The Content cannot, and is not intended to, replace the relationship that you have with your health care professionals. The Content on this website is not medical advice. You should always talk to your health care professionals for information concerning diagnosis and treatment, including information regarding which drugs or treatment may be appropriate for you. None of the information on this website represents or warrants that any particular drug or treatment is safe, appropriate or effective for you. Health information changes quickly. Therefore, it is always best to confirm information with your health care professionals.
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.

Because dental is not included in Original Medicare (unless medically necessary) or Medigap supplement plans, seniors must look elsewhere for dental coverage. So, dental insurance for seniors on Medicare can seem like a chore. But getting dental insurance when you’re using Medicare isn’t difficult, limited, or expensive. In fact, there are two different paths to take in order to find inexpensive coverage options.
The benefits of choosing MetLife are that they have a number of different plans available and they are well respected within the dental insurance industry. They have a broad network of dentists who work with them and they have significant coverage with a low deductible. The downside is that you have to visit dentists within their network in order to save.
My plan covered cavity fillings, but an additional procedure (like a crown or an extraction) would have been costly even with insurance. Multiple appointments also took up a lot of time. I could have spared myself some of those cavities, and long hours in the dentist’s chair, if I’d got regular cleanings in earlier years (and, of course, flossed more often).
Many provide as much as 100% coverage preventative services and then less on basic procedures usually 50% to 80%, and usually 50% to 0% on major care or things like crowns. Often there is some fine print with these plans and they do not cover certain procedures. They also have a maximum annual benefit and a deductible that you have to pay before they start coverage. There also can potentially be waiting periods on certain types of procedures but you don’t always have to get a referral to see a specialist.
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. 
No matter which type of plan you choose, we recommend that you carefully review your contract so you know exactly what your insurance will cover. Additionally, in most cases your dentist's office will be familiar with what your insurance may or may not cover. Since many dental offices will require you to pay the estimated uncovered balance upfront, you will need to make sure you know what that is in advance so you can plan your budget. If you cannot cover the remaining balance you may want to ask if your dentist provides financing.
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.
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