With the rising cost of going to the dentist, many people are struggling with the decision of whether or not to purchase dental insurance. Whether you are considering buying dental insurance through your employer or independently, be sure to investigate several different plans and ask questions about the factors listed below. This information will help you choose the right dental insurance plan before signing on the dotted line.
Dental insurance companies divide benefits, services, or procedures into categories and refer to them with American Dental Association (ADA) 3-4 digit code. As an example, Preventative and Diagnostic procedures often include exams (ADA code 0120), x-rays (ADA code 0210), and basic cleanings or prophylaxis (ADA code 1110). Basic procedures often include fillings, periodontics, endodontics, and oral surgery. Major procedures often are crowns, dentures, and implants. Procedures such as periodontics, endodontics, and oral surgery may be considered major, depending on the policy.
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.
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.
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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.
*The plan is insured by Delta Dental Insurance Company (Contract 1230) in AK, AL, DC, DE, FL, GA, LA, MD, MS, MT, NV, NY, PA, PR, TN, TX, UT, VI and WV, insured by Dentegra Insurance Company (Contract 1230) in AR, AZ, CA, CO, CT, HI, IA, ID, IL, IN, KS, KY, ME, MI, MN, MO, NC, ND, NE, NH, NJ, NM, OH, OK, OR, RI, SC, SD, VA, VT, WA, WI and WY, and insured by Dentegra Insurance Company of New England (Contract 1230) in MA. The plan is administered by Delta Dental Insurance Company. For Texas residents your Master Policy Form number is TX-AMD-MC-DPO-D-DC(DELTAUSA1-2005). These companies are financially responsible for their own products.
More sensitive teeth. Your teeth can become more and more sensitive as you age due to the natural gum receding process. As your gums recede, they expose sensitive areas of your teeth that aren’t protected by enamel. Extreme temperatures may cause more pain and discomfort in these areas. Using toothpaste designed for sensitive teeth should help. If your sensitive teeth continue to be a problem, you should visit your dentist, as your problem may be more serious.
Choosing a plan that’s right for you depends on many factors, including the ages and number of people in your family, and whether you or a family member needs orthodontic care. Some dental plans provide low copays, while others provide discounts on services. No matter which plan you select, you’ll have access to a large network of dental providers.