The reason why so many are uninsured might be because the economy is shifting towards more contract work, consultants, and freelancers. That’s left many people without an employer to pay the bill for things like health insurance and dental insurance. At the same time, many employers are cutting back on the benefits that they’re offering or shifting their benefits. Dental plans, which used to often be paid completely by the employer, might now be optional or require the employee to pay a significant portion of the costs. In that case, it could make more sense for you to shop for a plan that is a better fit for your needs and pay for your insurance yourself.
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.
You’ll want to go to an in-network dentist as they usually have better, contracted rates. We’ll show an example of that in a minute. Cleaning or preventative care visits are typically covered at 100%. Basic or major services visits are typically covered at 80% and 50%, respectively. What does this mean? If you go to an in-network dentist for a tooth filling (80%) whose contracted rate is $200, you’ll have to pay $40 out of pocket ($200 X (1 – .80)).
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.
The dental insurance and dental plan data on MedicareWire.com comes directly from public and private sources and is subject to change. The MedicareWire.com website is available for educational purposes. Our goal is to present information accurately and without bias, based on our interpretation of factual information. However, this site is not intended as a substitute for legal, health, or financial advice from a licensed professional.
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.
Almost all dental insurance companies use what is called a Usual, Customary, and Reasonable (UCR) fee guide. This means that they set their own price that they will allow for every dental procedure that they cover. This is not based on what a dentist actually charges, but what the dental insurance company wishes to cover. For example, your dentist may charge $78 for a dental cleaning, but your insurance company will only allow $58 because that is the UCR fee that they have set.
If you are changing insurance and want to continue with your current dentist, you can visit the websites of insurance companies you are thinking about signing up with and search to see if your dentist accepts the new type of insurance. However, sometimes these search results aren't updated or only show offices seeking new patients, so you'll want to verify by calling your dental office.
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.
Unfortunately, Original Medicare (Parts A and B) does not include coverage for services like dental exams, cleanings, fillings, crowns, bridges, plates, or dentures. There are some exceptions, such as when a hospital stay is involved, but otherwise, you would have to pay out of pocket for any routine dental services. For some of us, those expenses could add up quickly.
The Dental Care Cost Estimator provides an estimate and does not guarantee the exact fees for dental procedures, what services your dental benefits plan will cover, or your out-of-pocket costs. Estimates should not be construed as financial or medical advice. For more detailed information on your actual dental care costs, please consult your dentist or your Delta Dental.
© Delta Dental.This website is the home of Delta Dental of California; Delta Dental Insurance Company; Delta Dental of Pennsylvania; Delta Dental of New York, Inc.; Delta Dental of the District of Columbia; Delta Dental of Delaware, Inc.; Delta Dental of West Virginia, Inc. and their affiliated companies. For other Delta Dental Plans Association member companies, visit the Delta Dental Plans Association website. Delta Dental is a registered mark of Delta Dental Plans Association.
Aetna is based in Connecticut and was founded in 1853. They have over 30 million customers worldwide. They offer a number of different types of plans including DHMO plans where you pay a lower cost for your plan, but have to see a dentist in your network and need to get preauthorization if you need to be referred for specialty care. They also offer network option plans or PPO plans. These plans are more expensive and you have to pay 50% or more of the costs of your care. While you can see a dentist outside the network with these plans, they have many PPO dentist that you can use for a discounted rate. If you go out-of-network you will have to pay and get reimbursed later. You can also choose hybrid plans that offer some of the benefits of more than one plan.
When shopping for the best dental plans for seniors, you should consider what services and treatments you might need, the costs of the plan, and what the plan covers. The dental needs of seniors could depend on the condition of their current teeth and their dental history. For example, if you already have full dentures, you may be more concerned about getting checked for oral cancer than in cavity treatment or bridges.
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.
Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., and Cigna HealthCare of North Carolina, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see a listing of the legal entities that insure or administer group HMO, dental HMO, and other products or services in your state). Group Universal Life (GUL) insurance plans are insured by CGLIC. Life (other than GUL), accident, critical illness, hospital indemnity, and disability plans are insured or administered by Life Insurance Company of North America, except in NY, where insured plans are offered by Cigna Life Insurance Company of New York (New York, NY). All insurance policies and group benefit plans contain exclusions and limitations. For availability, costs and complete details of coverage, contact a licensed agent or Cigna sales representative. This website is not intended for residents of New Mexico.