Senior citizens across the U.S. are seeking coverage to aid in reducing their dental expenditures. Teeth, like bones, can soften as time passes and grow significantly more susceptible to degeneration and breakage. This can mean that seniors are often in need of more oral care than younger Americans, as they deal with broken teeth, loosened implants, gum problems, or other issues.
As a Medicare beneficiary, you are free to shop for a stand-alone private dental plan for seniors. Some dental plan types are PPO plans* and others are indemnity plans. A PPO stands for preferred provider organization. This is a type of plan that contracts with dental providers to create a network of participating providers. If you want to use a dentist out of network, you usually can for an additional cost. An indemnity plan allows you to visit almost any dentist you like with the plan paying a portion of your total charges. Indemnity plans are also called “fee-for-service” plans.
The key to keeping your teeth healthy as a senior is properly brushing and flossing your teeth, as well as visiting your dentist regularly for checkups and cleanings. You want to make sure to brush your teeth at least twice a day with toothpaste that contains fluoride, according to Colgate. The American Dental Association (ADA) notes that fluoride prevents tooth decay and cavities. It’s also important to floss once a day, says the ADA.
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.
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Generally Original Medicare dental coverage is only for limited circumstances involving hospitalization. Original Medicare (Part A and Part B) generally doesn’t cover most dental care, including cleanings, fillings, tooth extractions, dentures, and dental plates. Hospital insurance (Part A) may pay for emergency or complicated dental procedures, for example the reconstruction of the jaw following an accidental injury, according to the Centers for Medicare & Medicaid services (CMS). According to CMS, Congress has not amended the dental exclusion since 1980, when it made an exception for inpatient hospital services when the dental procedure itself made the hospitalization necessary. If you have Original Medicare and want routine dental care, you will generally need to find a plan from a private insurance company.
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.
The AARP Dental Insurance 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.
One of their popular plans is the My Dental Plan that allows you to customize your plan for what you need. It has a $50 deductible per person. You can customize the plan for either one or two cleanings per year and choose to have preventative care covered at 80% or 100%. When it comes to basic care, they offer the choice of 50% coverage and 80% coverage. For major car, they cover either 50% or 0% depending on the plan you choose. Their annual maximums are either $500, $1,000, or $1,500.
The best way to take care of your teeth is proper maintenance, and Dental Select’s senior dental plans cover 100% of preventative costs. This includes two professional cleanings each year, as well as exams and x-rays. Most of the costs of basic procedures are covered as well, such as fillings, dentures, and even oral surgery. Better yet, there are no waiting periods, meaning that your plan is effective on the first day of the month following your enrollment.
Most full coverage dental insurance plans will cover two preventive maintenance visits per year without requiring a deductible payment. Most require a $50 deductible per person, per year to help cover costs beyond your preventive exams. If you need work done, most plans will cover a part of the costs. We looked at root canals specifically and found that the majority of dental plans will cover about half the cost, which may not seem like a lot, but paying half is better than paying upfront for an $800 root canal. However, keep in mind that most insurance policies, depending on your plan, top out at about $1000 to $1500 per year. Using conservative estimates that might be one or two root canals. If you need extensive work done you might have to pay the remaining amount out of pocket.
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.”
As people get older, our medical and dental needs grow. It’s just a natural part of life, and so it’s important to take care of your body by giving it the proper care and attention it needs. Regular dentist visits for exams and professional cleanings are a crucial part of dental maintenance. Unfortunately, it seems that finding high quality dental insurance for seniors only gets more difficult.
2Delta Dental PPO is underwritten by Delta Dental Insurance Company in AL, DC, FL, GA, LA, MS, MT, NV and UT and by not-for-profit dental service companies in these states: CA – Delta Dental of California; PA, MD – Delta Dental of Pennsylvania; NY – Delta Dental of New York, Inc.; DE – Delta Dental of Delaware, Inc.; WV – Delta Dental of West Virginia, Inc. In Texas, Delta Dental Insurance Company provides a Dental Provider Organization (DPO) plan.
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.
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.
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.
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.