As a Medicare beneficiary, you are free to shop for a stand-alone private dental plan for seniors. Some dental plan types are PPO plans* and others are indemnity plans. A PPO stands for preferred provider organization. This is a type of plan that contracts with dental providers to create a network of participating providers. If you want to use a dentist out of network, you usually can for an additional cost. An indemnity plan allows you to visit almost any dentist you like with the plan paying a portion of your total charges. Indemnity plans are also called “fee-for-service” plans.
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).
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But for many, the perceived high cost of dental insurance is one of the key factors that is keeping them from getting a policy. Luckily, there are a number of different options for people at different price points. According to the National Association of Dental Plans, the average annual cost of coverage in 2009 (the most recent year the survey was conducted) for a dental HMO plan was around $225 per year for an individual or $445 per family, the cost of a dental PPO plan averaged around $285 for an individual and $866 per family, and indemnity plans cost an average of $288 for an individual and $666 for a family.
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).
You may have a preexisting oral health condition that is not covered by your current dental policy. Because discount plans are not insurance, they have no waiting periods. You can sign up today and be at the dentist in 30 minutes. If you’ve reached your annual maximum, you can use a discount plan to pay for a procedure you have been reluctant to get because of the out-of-pocket expense.
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.
I acknowledge and understand that by contacting My Family Life Insurance through any contact form, “Submit,” "Display Rates," "Apply Yourself" or other form means, I am providing my express consent that I may be contacted by My Family Life Insurance via e-mails, SMS, phone calls and prerecorded messages at any phone number(s) that I provide, even if the number is a wireless number or on any federal or state do-not-call list. I understand that calls may be placed using automated technology, and that consent is not a requirement for purchase. Your information will NOT be sold and will remain private.
Generally dental offices have a fee schedule, or a list of prices for the dental services or procedures they offer. Dental insurance companies have similar fee schedules which is generally based on Usual and Customary dental services, an average of fees in an area. The fee schedule is commonly used as the transactional instrument between the insurance company, dental office and/or dentist, and the consumer.

Depending on the type of insurance you’re looking at, the network of your dental insurance provider could be crucially important. Check to see how many dentists they have in their network and if your current dentist is in it or if there is a dentist who has an office near you that you would want to go to. Another thing to consider is whether the insurance provider will let you go see dentists outside their network, what the costs will be, and whether you need a referral when you need to see a specialist.
One example of a plan that is offered through eHealth is the Dominion Dental Services PPO Discount plan which has no deductible. They provide 100% coverage on most preventative and diagnostic procedures and 45% to 60% coverage on all other procedures including children’s orthodontics. They have no maximum annual benefit and they have no waiting period for things like cleaning, extractions, x-rays, and oral surgery but they have waiting periods but you have to use a dentist within their network.
In addition to companies listed here, you can check out other options by using a dental insurance search engine, such as the one available at the Dental Insurance Store. There you can plug in your age and ZIP code and get a list of plans available in your area. Along the left side of the screen, you can select various options that may be important to you – such as “no waiting period.”
When shopping for the best dental plans for seniors, you should consider what services and treatments you might need, the costs of the plan, and what the plan covers. The dental needs of seniors could depend on the condition of their current teeth and their dental history. For example, if you already have full dentures, you may be more concerned about getting checked for oral cancer than in cavity treatment or bridges.
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.
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.
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.

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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.
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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