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Many seniors have dental health issues, and hope that by purchasing a standard insurance plan they will be able to afford to get treatments that they have been delaying due to cost. Unfortunately traditional dental insurance often does not cover preexisting conditions, nor will it pay to replace teeth that were lost prior to purchasing the coverage.
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.
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).
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.
PPO Plan A is the most comprehensive plan with the highest number of services covered and still has a modest premium. PPO Plan A covers three cleanings and exams per year at no additional cost when visiting an in-network provider. There are no exclusions for most pre-existing conditions and dental implants are available after 1 year of continuous coverage. The annual deductible is $50 with an annual maximum of $1,500. You are allowed to visit any licensed dentist but with save money through using a preferred in-network provider.

The Dental Care Cost Estimator sometimes groups together, into "treatment categories," services that are often delivered together to address a particular dental problem. The description of different treatment categories, and the inclusion of particular services in a treatment category, is not advice that any particular treatment category is the right treatment for you or that you should not obtain any particular treatment. All of those matters are things that you should decide, in consultation with your dental care professionals. This cost estimator is intended for use in the 50 states, Puerto Rico and other U.S. territories. If you live outside the U.S., you may see information on this cost estimator about products or services that are not available or authorized in your country.
Seniors have special dental needs that come with getting older such as root decay, gum disease, tooth loss and more. Even non-dental conditions common to seniors, such as arthritis, can affect dental health. For those coming off of an employee group health plan upon after retiring, coverage may not be extended after you leave your job, leaving you to find your own dental coverage. Most plans have a waiting period for coverage, so this can leave you without coverage for a period of time.
Dental health is an important part of your overall wellness, and not having insurance may tempt you to skip regular cleanings and checkups – a decision that could lead to serious dental health problems down the road. Spirit Individual Dental Insurance plans are designed to help fill these types of gaps by offering a variety of plans and price points.

Learn more about:Dental InsuranceDental plans that fit your budget. Get and keep a healthy smile. Find PlansRelatedFinding the Best Dental Insurance in FloridaGetting Low-Cost Dental Insurance as a Self-Employed IndividualFinding Low-Cost Dental Insurance for Your Family as a Self-Employed IndividualFeaturedKey Health Insurance TermsObamacare 101: How Obamacare Health Insurance WorksHealth Insurance Products and Definitions var gf_global = {"gf_currency_config":{"name":"U.S. Dollar","symbol_left":"$","symbol_right":"","symbol_padding":"","thousand_separator":",","decimal_separator":".","decimals":2},"base_url":"https:\/\/www.ehealthinsurance.com\/resources\/wp-content\/plugins\/gravityforms","number_formats":[],"spinnerUrl":"https:\/\/www.ehealthinsurance.com\/resources\/wp-content\/plugins\/gravityforms\/images\/spinner.gif"}; Newsletter Sign up for our eHealth Newsletter email to receive updates that will help you! Email* This iframe contains the logic required to handle Ajax powered Gravity Forms. jQuery(document).ready(function($){gformInitSpinner( 1, 'https://s27829.pcdn.co/resources/wp-content/plugins/gravityforms/images/spinner.gif' );jQuery('#gform_ajax_frame_1').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_1');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_1').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 && ! is_redirect && ! is_confirmation;if(is_form){jQuery('#gform_wrapper_1').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_1').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_1').removeClass('gform_validation_error');}setTimeout( function() { /* delay the scroll by 50 milliseconds to fix a bug in chrome */ jQuery(document).scrollTop(jQuery('#gform_wrapper_1').offset().top); }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_1').val();gformInitSpinner( 1, 'https://s27829.pcdn.co/resources/wp-content/plugins/gravityforms/images/spinner.gif' );jQuery(document).trigger('gform_page_loaded', [1, current_page]);window['gf_submitting_1'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}setTimeout(function(){jQuery('#gform_wrapper_1').replaceWith(confirmation_content);jQuery(document).scrollTop(jQuery('#gf_1').offset().top);jQuery(document).trigger('gform_confirmation_loaded', [1]);window['gf_submitting_1'] = false;}, 50);}else{jQuery('#gform_1').append(contents);if(window['gformRedirect']) {gformRedirect();}}jQuery(document).trigger('gform_post_render', [1, current_page]);} );} );if(typeof gf_global == 'undefined') var gf_global = {"gf_currency_config":{"name":"U.S. Dollar","symbol_left":"$","symbol_right":"","symbol_padding":"","thousand_separator":",","decimal_separator":".","decimals":2},"base_url":"https:\/\/www.ehealthinsurance.com\/resources\/wp-content\/plugins\/gravityforms","number_formats":[],"spinnerUrl":"https:\/\/www.ehealthinsurance.com\/resources\/wp-content\/plugins\/gravityforms\/images\/spinner.gif"};jQuery(document).bind('gform_post_render', function(event, formId, currentPage){if(formId == 1) {if(typeof Placeholders != 'undefined'){
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).

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.
Estimating your possible dental costs may help you decide whether dental insurance would be financially beneficial. Dental insurance companies will show you a quote online so you can easily see what your premiums might be. You may want to compare your estimated yearly premiums to the cost of a year of procedures you want to have done. You can estimate how much your dental expenses might be either by talking with your dentist, or by researching costs online. You can use the estimates to help you decide whether you should pay out of pocket or plan your dental expenses based on your insurance coverage. Two resources for looking up procedure costs are The Fair Health Consumer Organization and the Guardian Insurance website. Estimated costs are sorted by zip code and will show a low and high rate so you can see a range of what a procedure may cost in your area.
You’ll pay less for your dental needs when you have coverage. Most procedures, even braces and dentures, come at a fraction of the price you’d pay without benefits. We also contract with dentists to offer you discounted rates, so you’ll only pay a portion of those reduced rates. Plus, our DeltaCare USA and Delta Dental PPO plans include a broad range of services to cover your oral health needs.
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