It's possible to purchase a dental-only insurance plan. You'll have to pay a monthly premium, but the cost will be offset by lower out-of-pocket fees. Most of these dental plans require that you see an in-network dentist who may offer lower rates than out-of-network providers. Some plans let you go to any dentist (in- or out-of-network), but you may have to pay more for their services.
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.
There can sometimes be significant differences between the dental insurance plans that employers sponsor and those that you obtain as an individual. One big (and obvious) difference is that usually employers pay for part or all of the dental insurance plan, whereas if you're buying a plan by yourself you have to pay for the whole thing. Some employers are also able to get a better deal because they're buying insurance in in bulk for all their employees. But, if you shop around, you could potentially get a plan that is similarly priced or even cheaper.
#wp_cta_10789_variation_0 .cta_content input[type=text], #wp_cta_10789_variation_0 .cta_content input[type=url], #wp_cta_10789_variation_0 .cta_content input[type=email], #wp_cta_10789_variation_0 .cta_content input[type=tel], #wp_cta_10789_variation_0 .cta_content input[type=number], #wp_cta_10789_variation_0 .cta_content input[type=password] {width: 90%;}
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.
« BackeHealth Insurance Resource CenterDental InsuranceDental Insurance for SeniorsDental Insurance for Seniors April 20, 2015 Learn about dental care concerns later in life, and dental insurance for seniors. ShareSenior citizens sometimes need special dental care. As we age, our teeth and gums are more susceptible to decay, inflammation, and disease. Health problems, like osteoporosis, diabetes, heart disease, stroke, and respiratory disease can also affect dental health, and sometimes the reverse is true, according to the Columbia University College of Dental Medicine and the American Dental Association.Why to consider dental insurance for seniorsOut of all out-of-pocket health-care costs, 27% of expenses are related to dental services, according to the Robert Wood Johnson Foundation; some people delay needed dental care because of the expense.Dental insurance isn’t usually included in major medical insurance policies, such as you may have from your employer. You can buy a stand-alone dental plan to cover some of your dental care costs.Keep in mind that dental insurance often requires a waiting period for more expensive treatments, so it’s best not to wait until you need dental insurance to get it.Standard dental policiesYou can buy a standard individual dental insurance plan, usually at a low monthly premium. Standard policies commonly cover these routine procedures, typically performed by family dentists:Regular cleanings and exams: Most policies entitle you to a free cleaning and comprehensive exam twice a year.X-rays: Dentists periodically take bitewing X-rays of your teeth. Depending on your dental insurance plan, x-rays may be fully covered, or you might make a copayment. Other X-rays of your mouth may require a copayment, coinsurance, or deductible.Fillings and extractions: Fillings (removal of decay and filling with a bonding material) and extractions (pulling a tooth out of your mouth) usually require a copayment, coinsurance or deductible in most dental insurance plans.Certain repairs: Standard individual dental insurance plans occasionally include partial coverage on some restorative procedures, such as root canals, crowns, bridges, and deep cleanings. Dental insurance plans usually require a copayment, coinsurance or deductible for these procedures, if they cover them. However, you might need to shop around for a policy that covers these more expensive services.  wp_cta_load_variation( '10789', '' )#cta_container{ border: 1px solid #dbdbdb; border-radius: 5px; } #wp_cta_10789_variation_0 #cta_container #content {background: transparent;}
For freedom of choice, there are a few types of plans to consider including PPO dental plans and Indemnity plans. PPO dental plans generally allow members to see any dentist, but they also include a listing of In Network dentists. With PPO’s you typically get more value if you see an In Network provider, but you can still choose to see an Out of Network provider too. Though Out of Network providers can bill for additional charges if they wish.
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.
When you near the age of 65, you need to sign up for Medicare. However, Medicare does not cover preventative dental care or other procedures such as fillings, tooth extractions, dentures or other dental devices. If you have a complicated or emergency dental procedure that requires hospitalization, Medicare Part A will likely cover the cost, but it is obviously preferable to avoid hospitalization if you can with regularly-scheduled dental care.
Enhanced dental policies for seniorsSome dental insurance policies pay for part of the costs for services beyond routine exams and fillings. Some examples include (but aren’t limited to):Endodontics: Root canals, or the removal of a tooth’s decayed or diseased pulp, are the most common use of endodontics. Your family dentist can sometimes perform this repair, or he or she may refer you to a specialist.Periodontics: Periodontal disease comes in many forms and could end up destroying supporting bones around the teeth. Treatment may include the placement of dental implants and treatment for inflammation. A specialist is often required.Dentures: Being fitted for dentures typically requires many extractions, making it a major procedure, possibly involving several visits. Some family dentists now fit patients for dentures. Specialty offices are more familiar with the process and sometimes offer a faster turnaround.Implants: Some adults who have lost a small number of teeth due to an accident or decay might get dental implants. Implants may eliminate the need for a bridge since the implant looks, feels, and works like a regular tooth. An oral surgeon rather than your family dentist typically does this procedure.Orthodontia: This type of service involves braces to align crooked teeth. Most family dentists offer orthodontia.Cosmetic services: Bonding, whitening, and veneers are sometimes covered under certain dental policies. Many family dentists offer whitening.  Types of dental plansThere are two major types of individual dental insurance plans that may apply to seniors:Managed-care plans (often preferred provider organizations, or PPOs) negotiate fees with specific providers. These in-network providers request only your portion of the cost and file any necessary paperwork on your behalf. Procedures performed by out-of-network providers are sometimes covered, but often at a lesser amount.Indemnity plans often include a larger group of providers and you may be able to see the dentist of your choice. The drawback is that patients are often required to pay 100 percent of the bill up front and then file a claim for reimbursement for the covered procedure.You can get help choosing an individual dental insurance planDon’t wait until you feel discomfort to get dental insurance. Many seniors take daily medications that cause dry mouth, which can lead to cavities. Inadequate nutrition can also affect your dental health, reports the Columbia University College of Dental Medicine.Keep in mind that some health problems, like pneumonia and insulin resistance, may be triggered by poor dental hygiene. Research has even found a connection between gum disease and heart disease, Intellihealth News Service reports.If you’d like to explore your options for individual dental insurance plans in your area, just click the button on the right side of this page. You can also request our newsletter in the lower right side of this page if you want to stay up to date on with health and insurance-related updates.This article is for informational purposes only. Nothing in it should be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine. In addition, this information includes just some factors to consider when selecting insurance and may not reflect the provisions of any particular insurance product. Always carefully check the provisions of any insurance product you have or may consider purchasing. wp_cta_load_variation( '10789', '' )#cta_container{ border: 1px solid #dbdbdb; border-radius: 5px; } #wp_cta_10789_variation_0 #cta_container #content {background: transparent;}
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).
Humana individual dental plans are insured or offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, The Dental Concern, Inc., CompBenefits Insurance Company, CompBenefits Insurance Company, CompBenefits Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc., Humana Health Benefit Plan of Louisiana, Inc., or DentiCare, Inc. (DBA CompBenefits). Discount plans are offered by HumanaDental Insurance Company, Humana Insurance Company, or Texas Dental Plans, Inc. For Arizona residents: Insured by Humana Insurance Company. For Texas residents: Insured or offered by Humana Insurance Company, HumanaDental Insurance Company, or DentiCare, Inc. (DBA CompBenefits).

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.


No individual applying for health coverage through the individual Marketplace will be discouraged from applying for benefits, turned down for coverage, or charged more premium because of health status, medical condition, mental illness claims experience, medical history, genetic information or health disability. In addition, no individual will be denied coverage based on race, color, religion, national origin, sex, sexual orientation, marital status, personal appearance, political affiliation or source of income.
×