Copyright © 2011–2018 Delta Dental of Tennessee | All Rights Reserved | 240 Venture Circle, Nashville, TN 37228 | (800) 223-3104 The information provided on this site is for general education purposes only and is not intended as a diagnosis, treatment, or a substitute for professional medical or dental advice, diagnosis, or treatment. Consult your dentist or physician for information or treatment specific to you and your health.
Our dental insurance plans include options to see ANY DENTIST YOU LIKE or choose from 400,000 + access points nationally. The dentists and dental providers in the network dental insurance plans have agreed to provide discounts to our plan members for the same quality treatments and procedures that they provide to non-members. When you visit the dentist, you pay the discounted price and save!
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.
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.
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.
One example of a plan that is offered through eHealth is the Dominion Dental Services PPO Discount plan which has no deductible. They provide 100% coverage on most preventative and diagnostic procedures and 45% to 60% coverage on all other procedures including children’s orthodontics. They have no maximum annual benefit and they have no waiting period for things like cleaning, extractions, x-rays, and oral surgery but they have waiting periods but you have to use a dentist within their network.
Once you purchase a dental insurance plan and start paying your premiums, most preventive care like cleanings and check-ups are covered immediately. For more serious procedures, after you meet your deductible, you’ll only be responsible to pay your percentage of the cost. And we’ll pay the rest. Also, some dental plans have an out-of-pocket maximum to protect you from high costs throughout the year. On some plans, if you reach this maximum, we’ll pay the full cost of any additional care until your annual maximum benefit is met.
Another thing to consider when looking for dental plans for seniors is the waiting period some plans may have for certain services. For example, a plan may set a 3-month waiting period for an extraction. This means that if you get an extraction a week after enrolling in that plan, you usually won’t be covered. Some services may have longer waiting periods, such as 15 months, before the plan covers that service. This is why it is best to not wait until you have a dental emergency to enroll in a dental insurance plan.
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.
For freedom of choice, there are a few types of plans to consider including PPO dental plans and Indemnity plans. PPO dental plans generally allow members to see any dentist, but they also include a listing of In Network dentists. With PPO’s you typically get more value if you see an In Network provider, but you can still choose to see an Out of Network provider too. Though Out of Network providers can bill for additional charges if they wish.
The cost of not taking care of your oral health could be more. Those without individual dental coverage are less likely to get routine dental care, meaning they seek out a dentist only when they have a problem. By then, more extensive and more expensive measures may be necessary, and major problems linked to poor oral health (like heart disease and diabetes) are more likely to appear.2 Doing nothing now means you might pay more later.