With an extensive network of more than 100,000 participating dentists at more than 300,000 locations nationwide, there is likely an in-network dentist in your area. When you combine the ability to choose your preferred dentist with the kind of comprehensive coverage available through one of the largest providers in the dental insurance sector, you’ll find Guardian dental is tough to beat.
The final kind of dental insurance is indemnity dental coverage. These plans allow you to visit any dentist and they will pay a fee for the procedures you have done. They calculate a set amount that they’ll pay for each type of procedure and any additional amount would have to be paid by you out-of-pocket. They also have an annual maximum which can sometimes be higher than other types of plans. One of the downsides is that you have to pay for all the services upfront and submit paperwork in order to get reimbursed.
If you are a senior or are approaching retirement, you may be surprised to find out that Medicare does not provide coverage for routine dental care. Medicare mainly covers medical treatments, but does not provide any assistance for routine dental care such as bi-annual exams, cleanings, or even major services like bridges or dentures. This leaves it to seniors to search for a dental plan that can meet their coverage needs.
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.

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)).


Our health benefit plans, dental plans, vision plans, life and supplemental plans, workplace voluntary benefit products, long term disability plans, and short term disability plans have exclusions, limitations, and terms under which the coverage may be continued in force or discontinued. Our dental plans, vision plans, life and supplemental plans, workplace voluntary benefit products, long term disability plans, and short term disability plans may also have waiting periods. For costs and complete details of coverage, call or write Humana or your Humana insurance agent or broker.
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.
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Different companies provide various percentages of coverage in these areas. For example, one insurance provider might cover 100% of the cost of Class I services while another might only cover 80%. Yet another plan might not provide Class IV or orthodontic coverage, but provide coverage in all other areas. It’s important that you understand what services are covered before signing up for a plan.


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.
If you go to an out-of-network dentist, then the plan usually pays based on the UCR fee. For example, if the dentist charges $250 for the filling, but the UCR in your area is $150, you could end up paying more. In this case, $130 ($250 – $150 X (.80)). This also introduces the concept of balanced billing, which means paying the dentist the cost difference between their rate ($250 in this case) and the cost-sharing rate ($120).
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. 
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.
There can sometimes be significant differences between the dental insurance plans that employers sponsor and those that you obtain as an individual. One big (and obvious) difference is that usually employers pay for part or all of the dental insurance plan, whereas if you're buying a plan by yourself you have to pay for the whole thing. Some employers are also able to get a better deal because they're buying insurance in in bulk for all their employees. But, if you shop around, you could potentially get a plan that is similarly priced or even cheaper.
Enhanced dental policies for seniorsSome dental insurance policies pay for part of the costs for services beyond routine exams and fillings. Some examples include (but aren’t limited to):Endodontics: Root canals, or the removal of a tooth’s decayed or diseased pulp, are the most common use of endodontics. Your family dentist can sometimes perform this repair, or he or she may refer you to a specialist.Periodontics: Periodontal disease comes in many forms and could end up destroying supporting bones around the teeth. Treatment may include the placement of dental implants and treatment for inflammation. A specialist is often required.Dentures: Being fitted for dentures typically requires many extractions, making it a major procedure, possibly involving several visits. Some family dentists now fit patients for dentures. Specialty offices are more familiar with the process and sometimes offer a faster turnaround.Implants: Some adults who have lost a small number of teeth due to an accident or decay might get dental implants. Implants may eliminate the need for a bridge since the implant looks, feels, and works like a regular tooth. An oral surgeon rather than your family dentist typically does this procedure.Orthodontia: This type of service involves braces to align crooked teeth. Most family dentists offer orthodontia.Cosmetic services: Bonding, whitening, and veneers are sometimes covered under certain dental policies. Many family dentists offer whitening.  Types of dental plansThere are two major types of individual dental insurance plans that may apply to seniors:Managed-care plans (often preferred provider organizations, or PPOs) negotiate fees with specific providers. These in-network providers request only your portion of the cost and file any necessary paperwork on your behalf. Procedures performed by out-of-network providers are sometimes covered, but often at a lesser amount.Indemnity plans often include a larger group of providers and you may be able to see the dentist of your choice. The drawback is that patients are often required to pay 100 percent of the bill up front and then file a claim for reimbursement for the covered procedure.You can get help choosing an individual dental insurance planDon’t wait until you feel discomfort to get dental insurance. Many seniors take daily medications that cause dry mouth, which can lead to cavities. Inadequate nutrition can also affect your dental health, reports the Columbia University College of Dental Medicine.Keep in mind that some health problems, like pneumonia and insulin resistance, may be triggered by poor dental hygiene. Research has even found a connection between gum disease and heart disease, Intellihealth News Service reports.If you’d like to explore your options for individual dental insurance plans in your area, just click the button on the right side of this page. You can also request our newsletter in the lower right side of this page if you want to stay up to date on with health and insurance-related updates.This article is for informational purposes only. Nothing in it should be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine. In addition, this information includes just some factors to consider when selecting insurance and may not reflect the provisions of any particular insurance product. Always carefully check the provisions of any insurance product you have or may consider purchasing. wp_cta_load_variation( '10789', '' )#cta_container{ border: 1px solid #dbdbdb; border-radius: 5px; } #wp_cta_10789_variation_0 #cta_container #content {background: transparent;}
A dental plan is not dental insurance, but is instead a way to get discounts on the care you need. Their dental plans offer savings of anywhere from 10% to 60% on dental procedures with no limits or wait times to get care. With dental plans, you also do not have to fill out time consuming paperwork - you can simply go to a dentist that you choose within their network and get the services you need.
Different companies provide various percentages of coverage in these areas. For example, one insurance provider might cover 100% of the cost of Class I services while another might only cover 80%. Yet another plan might not provide Class IV or orthodontic coverage, but provide coverage in all other areas. It’s important that you understand what services are covered before signing up for a plan.
Although discount plans are also sold by private companies, they are not insurance plans. There are no copays, coinsurance, or deductible amounts. That also means that there are no pre-negotiated rates or free yearly checkups and cleanings. A participating dentist simply agrees to offer discounts (often a percentage off from the total price) for certain medical services. Then, seniors who choose discount plans will pay their dentist directly for the cost of services (after the discount).
Dental providers contract with dental savings plans to provide the same quality dental work at reduced prices. The concept is a familiar one – it’s the same model used by discount clubs like Costco and Sam’s. Dentists realize that for many seniors, insurance is not the best option and, in many cases, doesn’t provide all of the coverage they really need. You benefit by gaining access to discounts of up to 60% on routine and major oral healthcare.

Dental Health Maintenance Organization plans entail dentists contracting with a dental insurance company that dentists agree to accept an insurance fee schedule and give their customers a reduced cost for services as an In-Network Provider. Many DHMO insurance plans have little or no waiting periods and no annual maximum benefit limitations, while covering major dental work near the start of the policy period. This plan is sometimes purchased to help defray the high cost of the dental procedures. Some dental insurance plans offer free semi-annual preventative treatment. Fillings, crowns, implants, and dentures may have various limitations.
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In general the dental insurance companies at the top of our review list provide a range of plan options to numerous areas of the country. We also considered average yearly preventive care costs across numerous zip codes and compared that number to possible yearly premium costs. This helps predict whether the premium costs would, on average, be less than the cost of preventive care paid out of pocket. Keep in mind that co-pays and other small fees might also determine whether you will break even by paying for dental insurance, but our numbers can give you a general idea of what you can expect. It was not surprising to learn that those who charge a higher premium may cover more and those with a lower premium might cover less. This means that if you pay more monthly you might receive more complete coverage, and if you pay less per month you might be expected to pay a bit more during the time of treatment. So you'll need to decide whether you want to pay more per month or make up a bit of the difference when you visit your dentist.

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:

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