Most people know that they need to visit a dentist regularly. Having dental coverage is strongly associated with how often dental services are used. Americans often say that the cost of dental care and the lack of dental coverage are reasons for not getting needed dental care. Having an individual dental insurance plan from Spirit Dental allows you to get the regular care you need to stay healthy.

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.
People buying their own dental insurance (as opposed to those covered by an employer's plan) sometimes get a nasty surprise when they sign up: a waiting period. Unlike regular health insurance, in which coverage usually starts immediately or at the beginning of the next month, dental plans often come with a delay between enrollment and the actual onset of coverage for some or all services. It could be six months to a year or more.

The dental insurance and dental plan data on MedicareWire.com comes directly from public and private sources and is subject to change. The MedicareWire.com website is available for educational purposes. Our goal is to present information accurately and without bias, based on our interpretation of factual information. However, this site is not intended as a substitute for legal, health, or financial advice from a licensed professional.
As people get older, our medical and dental needs grow. It’s just a natural part of life, and so it’s important to take care of your body by giving it the proper care and attention it needs. Regular dentist visits for exams and professional cleanings are a crucial part of dental maintenance. Unfortunately, it seems that finding high quality dental insurance for seniors only gets more difficult.

Another kind of dental insurance plan is a DPPO which is similar to a health insurance PPO plan. What they do is they work out lower rates with dentists that are in their network who are often referred to as their preferred providers. With this plan, you can visit a dentist outside of your network, but you will not be able to get these low rates and you will likely end up paying more. Many DPPOs provide coverage of preventative care, basic procedures, and major procedures, but they only provide a percentage of this care for each.

Humana has a loyalty rewards dental program which increases coverage over time, making it an attractive choice for seniors seeking dental coverage. Plans, coverage options and premium vary by state. Another great option for seniors is the ability to purchase vision insurance in combination with the Humana dental plan. If you purchase both individual dental and

Another option for dental care is Medicaid, which covers some kinds of dental procedures if you meet the requirements. Medicare does not provide dental coverage. The ADA Foundation has provided dental care to 5.5 million children since 2003. They will direct you to a dentist that is near you. Another option is the Children Health Insurance Program (CHIP). It provides health coverage including dental coverage to over 7 million children under 19 years of age.
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.
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.
DentalPlans.com provides dental coverage to more than 1 million customers across all 50 states. DentalPlans.com has an extensive network including more than 100,000 dentists across the country. Although DentalPlans.com is not an insurance company they work to reduce the cost of dental repairs, as well as covering those who may need to visit an out-of-network dentist.

An example of Delta Dental’s offerings is their Dental for Everyone Gold PPO plan which includes savings that change depending on what year of the plan you're in. When it comes to preventative care, they offer 60% coverage in the first year, 80% in the second year and 100% in the third year and going forward. For basic care, they offer 50% coverage in the first year, 65% of the second year, and 80% in the third year and going forward. For major care, you get 0% coverage in the first year, 30% in the second year, and 50% in the third year.


Examples of dental costs with the Careington 500 plan are $15 for an oral exam, $31 for a cleaning, $483 for a crown and 64 percent off of dentures. The prices quoted on the website are in the Fort Worth, Texas area, with savings of 60 to 74 percent off dental services and 20 percent off orthodontia. Cost of procedures may vary depending on your location.
There are many insurance companies that offer dental services to seniors. Many are part of the group of insurance companies that fall under Medicare part C. While every insurance company under Medicare Part C offers the same medical coverage as Medicare Part A and Part B, they sometimes offer additional services such as dental coverage. Even so, the types of dental coverages that they offer are not identical.
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.
No matter which type of plan you choose, we recommend that you carefully review your contract so you know exactly what your insurance will cover. Additionally, in most cases your dentist's office will be familiar with what your insurance may or may not cover. Since many dental offices will require you to pay the estimated uncovered balance upfront, you will need to make sure you know what that is in advance so you can plan your budget. If you cannot cover the remaining balance you may want to ask if your dentist provides financing.
Examples of dental costs with the Careington 500 plan are $15 for an oral exam, $31 for a cleaning, $483 for a crown and 64 percent off of dentures. The prices quoted on the website are in the Fort Worth, Texas area, with savings of 60 to 74 percent off dental services and 20 percent off orthodontia. Cost of procedures may vary depending on your location.

Blue Cross Blue Shield has a plan called BlueCare that does not have a waiting period for preventative services and many non-surgical procedures. United Healthcare's United Health One is another. Major surgical treatments and restorative work do require some wait time, though that can be curtailed to some extent if you're coming off another dental plan.
My plan covered cavity fillings, but an additional procedure (like a crown or an extraction) would have been costly even with insurance. Multiple appointments also took up a lot of time. I could have spared myself some of those cavities, and long hours in the dentist’s chair, if I’d got regular cleanings in earlier years (and, of course, flossed more often).
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.

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.
By using this website, I confirm that I understand and agree to the applicable Privacy Policy and Terms of Service. I understand that by calling the phone number above I will reach a licensed sales agent. *Not connected with or endorsed by the United States government or the federal Medicare program. Medicare has neither reviewed nor endorsed this information. Copyright © 2018 Medicarehealthplans.com. All rights reserved. 5202 W. Douglas Corrigan Way, Suite 300, Salt Lake City, UT 84116. Medicarehealthplans.com is a free information source designed to help find insurance coverage. Whether you are looking for a Medicare Advantage Plan, a Prescription Drug Plan or a Medicare Supplemental plan, our licensed agent can help you find the right coverage options. We compile our data from multiple sources, which includes the government, non-profit and private sources. The rates and information displayed is for informational purposes only, and should not be construed as advise, consult, or recommendation. For specific plan details and further information, contact the carrier directly.
MedicareWire.com is privately owned and operated. We are a non-government resource, providing information about senior health insurance, Medicare, life insurance and other senior products for consumer research and education. This website and its contents are for informational purposes only. If you're looking for the government's Medicare website, please browse to www.medicare.gov.
MedicareWire.com is privately owned and operated. We are a non-government resource, providing information about senior health insurance, Medicare, life insurance and other senior products for consumer research and education. This website and its contents are for informational purposes only. If you're looking for the government's Medicare website, please browse to www.medicare.gov.
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)).
The AARP Dental Insurance 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.
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).
However, if your insurance does not cover cleaning and preventative care at 100%, then you will have to pay the remaining costs of your visit. This can cost anywhere from $20 to over $100 depending on the type of care you’re getting and the percentage covered. If you’re getting a PHMO plan, it is easier to estimate your costs since all procedures conducted in their network will have fees, but if you’re going to your own dentist then it will simply be a percentage of whatever they charge.
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).
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.
×