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.
They have a popular dental PPO plan called MetLife 2-9 Dental. They negotiate fees within their network of dentist which are lower than average and cover over 400 procedures. They offer 100% coverage on preventative care, 80% coverage on basic care, and 50% coverage on major care with a $50 deductible. Their annual maximum coverage amount is between $1,000 and $1,500.
DHMO's are similar to HMOs in that their plans connect you with a network of dentists who give you care for a low monthly premium. With DHMO plans, you are required to go see dentists who are in their network, but in return you have lower costs, and no claim forms to fill out. DHMOs are great for preventative care and basic procedures. Some downsides include that there can be wait times if you need major or restorative dental care and some DHMOs don’t cover this types of treatment. You also need to go see your primary care dentist and get a referral to a specialist in order to get some specialized care.
Spirit Dental is the online storefront for Direct Benefits, a company started in 2001 by Tom Mayer, who wanted dental coverage to be affordable for all Americans. While Direct Benefits serves as a broker for employee benefits and consultants, Spirit Dental is meant for online consumers who can buy coverage right on the website or talk to one of their many agents and providers nationwide.
The cost estimates provided may be different from your actual costs for several reasons, including but not limited to, your unique dental circumstances and the decisions made by you and your dental professionals as to what services you will receive, deviations between the anticipated scope of services and the services actually provided, and the characteristics of your particular plan.
In either case, in our opinion, the purchase of dental insurance can be hard if you don’t do your homework. Why? The premiums aren’t in favor of the benefit. For example, if you are paying $100 per month for dental insurance which has an annual benefit of $1,000, that really isn’t in your best interest. You are paying $1,200 annually for a $1,000 benefit. In this case, it is better to simply negotiate a discount with the dentist or utilize a dental discount plan where appropriate (more on that below).
Another downside of buying your own dental insurance is that you might not be able to afford the same type of coverage, which means that you could potentially have fewer benefits than you would if you had gotten it through your employer. That might mean that you have less access to certain types of treatment or that in order to get an affordable plan with good coverage, you’ll have to choose one where you have to stay within the plan’s network.
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.
This information is provided by Ameritas Life Insurance Corp. (Ameritas Life). This provides a very brief description of some of the important features of this insurance policy. It is not the insurance policy and does not represent it. A full explanation of benefits, exceptions and limitations is contained in the Individual Dental Policy Form Indiv. 9000 Rev. 07-16 and Vision Policy Form Indiv. 9000 Ed. 07-16-V. Premium rates may change upon renewal. This policy is renewable at the option of the insured. This product may not be available in all states and is subject to individual state regulations.
There are few procedures that most insurance companies will not cover or only provide a discount for. Most individual dental insurance plans do not cover what might be considered cosmetic procedures such as tooth-colored fillings on molar or bicuspid teeth, dental implants or adult cosmetic orthodontics. The majority of dental companies will also limit how often certain appliances can be replaced and, in most cases, will not replace lost items. The limitations are published in the disclosures and contracts for the plan, many of which you can peruse online. Keep in mind that a new dental insurance plan is not going to cover an emergency you are experiencing right now; most have a waiting period of six to 12 months for major work. (However, some will waive the waiting period if you recently had dental insurance.) Dental groups that offer dental discount plans will let you use your benefits right away, but they only provide a discount and not full coverage. Full coverage plans will however cover your initial evaluation so you can start planning your dental procedures.
Most dental insurance companies have a waiting period after your application is accepted. This practice is so the customer doesn’t wait until they have accumulated the need for several procedures to buy and use dental insurance to cover the costs. Most plans have a waiting period for some procedures but not others, like a regular checkup. One of our best dental insurance companies has no waiting period for just about any procedure.
Like most kinds of health or ancillary medical insurance, there are deductibles involved in dental insurance. Generally, the deductibles are per individual or per family depending on your plan. Some companies require that you meet the deductible on each member of your family while others have a family amount that you have to hit – no matter who the person receiving the care was. Deductibles can range anywhere from $100 to $500 or more. Obviously, the higher your deductible, the less likely you’ll be to take full advantage of your insurance.
Preventive care may seem optional if you have healthy teeth and good oral hygiene, but it saves money in the long run. I went without dental insurance for three years in my twenties, and did what most of my peers did in that situation – simply didn’t visit the dentist. Then I enrolled in a graduate program which required students to have medical and dental coverage. At my first dental visit, I had numerous cavities. Getting them all filled required nine or ten appointments in the nine months of my academic year.
We evaluated 24 dental insurance companies and found the three top choices for seniors based on the cost of premiums, the number of in-network dentists and overall cost savings. Our top three picks are DentalPlans.com, Spirit Dental and 1Dental.com. In this guide, we will discuss what you need to look for in dental insurance, why seniors need dental insurance and we’ll share details about the top companies. We included helpful frequently asked questions about dental insurance as well.
Our top three choices offer an excellent selection of policies and discounts that can protect your savings without requiring you to pay excessive premiums. The companies service almost all markets in the U.S. Remember that you can probably go out of network to see the dentist you prefer, but you will pay more out of pocket for doing so. If you have a favorite dentist, call their office to ask what dental insurances consider them in-network.
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.
Medicare Health Plans is more than just Medicare plans! We work with seniors for all of their insurance needs. One of the most common types of insurance that seniors ask about is dental insurance. Since routine dental care is not included in Medicare and the “gateway” to your body is too important to ignore, seniors want dental insurance options. We represent multiple carriers and plans and believe we have the plans that will best fit your needs.
*Examples only. These are the average costs the patient will pay per procedure with an in-network provider and are based on averages across Atlanta, Cincinnati, Los Angeles, Manhattan and Saint Louis. Actual costs and savings may vary by provider, geographic area, and service received. There are limitations and exclusions to the discount available. For example, general anesthesia, implants, and/or cosmetic dentistry are not discounted services. Upon purchase, refer to your policy for more information on the limitations and exclusions that apply. Coinsurance listed is for Prime Plan C.
These plans, sometimes called "Medigap" plans, are a type of insurance you can get to help cover costs like deductibles and coinsurance. You pay a monthly premium for the supplement, just as you would any kind of insurance. After Medicare pays its part, the supplemental insurance kicks in. You must have both Parts A and B of Original Medicare before purchasing a Medigap plan.
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.
Humana group dental plans are offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, Humana Health Benefit Plan of Louisiana, The Dental Concern, Inc., Humana Medical Plan of Utah, CompBenefits Company, CompBenefits Insurance Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc., or DentiCare, Inc. (DBA CompBenefits).