Preventive care is 100% covered with 2 exams and 3 cleanings free per year. There is a $100 deductible that you only pay once for the life of your plan. After the deductible is met, the plans cover between 80% to 90% of all basic care and 50% to 65% of major work including crowns, bridges, implants, and root canals. Orthodontia is covered at 50% and all plans are highly affordable, with their lowest individual plan often running at less than $115 per month depending on your region. Their highest-tier plan offers a $5,000 maximum benefit per year but isn’t available in every state.
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.
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.
If you are on a policy that requires you to go to a participating provider, you should not be charged the difference between these two prices. A contracted dentist generally has an agreement with the insurance company to write off the difference in charges. If the policy allows you to go to a dentist or pediatric dentist of your choice, check the insurance company’s UCR fee guide against the fees that dentist charges. You may be required to pay the difference out of your pocket, however, you cannot put a price tag on quality dental care.
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.