Dental Insurance For Seniors
We evaluated more than 20 dental insurance companies and after careful consideration, we chose 6 of the best dental insurances for seniors to review.
Best Dental Insurances For Seniors
What You Should Consider
Dental insurance tends to be relatively affordable for most seniors, but not all treatments are covered equally. There are varying classes of service within your policy, which means that your premium alone will grant you access to some procedures at no additional cost, but your company may ask you to share the expense on some other procedures you have. Routine checkups and cleanings won’t cost you anything beyond your premium but depending on your plan you’ll have to pay around 10 or 20 percent of common procedures like root canals or fillings. Procedures with a larger price tag on them will typically receive around 50 percent coverage from your insurance policy, which means you’ll still have to pay the other half out of pocket.
Dental insurance plans typically have an annual maximum payout, which means that your insurance plan will only provide for between $1,000 and $5,000 in operations per year.
As a side note, many insurance plans include coverage for orthodontics. Orthodontics fit into a slightly different category of coverage, which typically has a lifetime maximum rather than annual. For seniors, it might be wise to choose dental insurance plans that exclude orthodontic coverage, unless you suspect you might need it.
Medicare & Medicaid Coverage of Dental Cost
Although Medicare Part A and B (often known as Original Medicare) provide a wide range of health care benefits for millions of people, you should note that with regard to routine dental care coverage, it is often considered to be quite light as it does not provide for most areas of dental care. As a result, you would pay 100% for services that are not covered, which happens to be most forms of dental care. Dental exclusions are provided by the Social Security Act, section 1862 (a) (12).
- Part A (hospital coverage) – This covers some dental services that are administered within a hospital as well as certain complicated dental procedures and emergency dental care.
- Part B (medical coverage) – Coverage is for specified conditions where an examination is required up front, but it does not cover removing teeth prior to dentures or those related to teeth and their supporting structures.
The lack of coverage from Medicare, where some have no dental coverage at all, leads you to either buying a dental plan, considering Medicare Advantage or paying out of pocket.
When you look for a dental plan, you can secure various levels of savings, whereas, if you settle for out-of-pocket dental costs, the statistics vary widely, but the gist of it is that you can end up with substantial costs.
What Medicare does cover?
- Dental services that are an integral part of a covered procedure (for example jaw reconstruction)
- Inpatient hospital care where the underlying medical condition or severity of the dental work requires hospitalization.
- Oral examinations preceding heart valve replacement and kidney transplantation
- Extractions that are preparation for radiation treatment for diseases involving the jaw
What Medicare does not cover?
Preventative dental care
- Oral exams
- Dental cleanings
Minor restorative services
- Tooth extractions
Major restorative services
- Root canals
- Oral surgery
By selecting a Medicare Advantage plan (commonly referred to as Part C), you can access some benefits of dental coverage, for example routine dental care coverage and access to a network of qualified dentists but these benefits will vary according to the plan chosen. It is in general a build upon Medicare. In 2018, the average premium was roughly $35 per month ($420 a year).
Through Medicaid you can receive a source of dental coverage, however it depends on what state you are in for the dental benefits you may receive. State Medicaid programs are not required to cover dental benefits, it is optional.
You may qualify for full dual eligible or part dual eligible.
- Full dual eligible – With this you are generally eligible to receive full Medicaid benefits, such as dental coverage providing it is covered by the state. The range of benefits will vary from state to state.
- Partial dual eligible – You may receive assistance from Medicaid but no other benefits.
The state benefits available may change over time, for example due to budget constraints.
PPO, HMO or Dental Discount Plan
Dental policies come in many different shapes and sizes. Insurance companies have several different approaches to coverage, so one of them will fit you better than others. Most of the distinctions between these three categories have to do with how the providers you use are structured.
Preferred Provider Organizations, or PPOs for short, are the most common insurance plan. They are based around organized networks of dentists who work with the insurance company to reduce the rates for your dental care. While you can still go out-of-network, it wouldn’t be a very good decision because you wouldn’t get the reduced rates your plan offers. If you already have a preferred dentist, it’s recommended to check and see if they’re in-network before you buy your insurance.
A health maintenance organization, or HMO for short, is a very low-cost alternative to PPOs that covers close to nothing besides the routine visits and “maintenance” operations you get on a regular basis, like cleanings. You’d have to pay for everything else completely out-of-pocket, which makes this plan unwise for seniors who might need more serious procedures done.
Dental Discount plans are a relatively new policy that lets you pay a small premium and choose from a group of dentists who have agreed to give you discounted service. You pay everything out of pocket at the time of service, but a much smaller amount than you would have otherwise.
Is Dental Insurance Worth the Cost?
The idea of dental insurance can be a fantastic addition to your life and be a great asset to your dental care. When considering dental insurance, you have different factors to weigh up, such as how much coverage you looking to receive and what the deductible is.
Coverage for dental procedures can vary and tend to be down to the type of procedures covered:
- Preventative care – You may usually be covered up to 100%. This may include for example x-rays, exams and routine cleanings.
- Basic procedures – Such as periodontal work, fillings, extractions and root canals (a root canal may be considered either a basic or major procedure) may be covered to a degree, bearing in mind you have paid your deductible.
- Major procedures – Dental work such as dentures, crowns, implants and bridges. This may be covered, but only for a small percentage.
Another consideration is the dentist you decide to use and with this we mean whether you decide to use an in-network dentist or an out-of-network dentist. If you select an in-network dentist then you may benefit from more coverage whereas if you choose to go with an out-of-network dentist then you are likely going to end up paying more. Again though, you must factor in your dental use before signing up to dental insurance. This is because you may have previously been using what would be considered as an out-of-network dentist but you have a trusting relationship with them and may wish to stick with them.
You always would need to look around for the most suitable coverage limit as once you have reached your prescribed limit, your dental insurance would end and you would end up out-of-pocket as you would be liable to pay for the additional costs. However, as mentioned you can pick the most suitable limit for yourself and it is estimated that only between 2% – 4% of users in the USA managed to use their full benefit.
It is essential that you are well-informed on what is covered and the level of coverage before you make any procession with dental insurance. You should also make yourself aware that there is an alternative to dental insurance, which would be a dental discount card.
How ‘worth it’ dental insurance is depends on you and your use of it, but it can be a good nudge to make you be more active and make sure you care for yourself dentally. For example, it is recommended you make two preventative-care appointments a year and you are more likely to do this if you have already paid for it through your dental insurance. Your personal circumstances also matter, as for example seniors tend to face more requirements for dental care and this will only increase with age.
Also, do not forget that dental insurance and the price of it varies according to where you live, but usually you will be looking at paying less than $100 a month.
Below is an example of some dental procedures and their costs, whether it is insured or uninsured. Although this is a representative table, do take into consideration that the costs for dental procedures vary from state to state as does the level of coverage you may receive from your dental insurance.
|Dental Procedure||Uninsured Cost||Insured Cost|
|Teeth cleaning||$127||100% covered up to twice per year|
|Cavity filling||$204||On average 50% – 80% of the cost|
|Wisdom tooth removal||$250 – $750||$416|
|Root canal||$957 – $1,156||$333 – $608|
Questions to Ask About Dental Insurance
It’s very wise to ask lots of questions about your prospective insurer’s services before you buy. Getting stuck with an insurer who can’t take care of your needs is worse than not having anything at all, so make sure that you consider your options carefully before spending. Here are some questions you should ask:
- Are there any restriction for pre-existing conditions and are there any waiting periods?
- Which treatments are covered? Which treatments are paid in full and which are only paid partially?
- What’s the deductible? This the amount you have to pay before the threshold is reached and the insurance steps in.
- What’s the yearly limit after which you’ll have to pay yourself for treatments?
- Which treatments need to be pre-approved by the provider before receiving them?
- Will you be forced to go with a cheaper treatment, even if the dentist recommends a higher priced one? If so, what would be your out-of-pocket costs?
- Is there a limit on cleanings and exams that will be covered by provider each year?
- What are the time limits for dentures, bridges and crowns?
- How often is a full series of x-rays covered?
- Are there enough in-network dentists in your area?
- Is your current dentist in-network?
Why Seniors Should Consider ItAs you grow older, dental care becomes steadily more important. Common changes among seniors, like softening bones and teeth or dry mouth, can cause a wide variety of health issues to become more likely. If you visit a dentist regularly, you’ll avoid many of the expensive medical operations that those issues can require. You’ll save money and avoid pain by scheduling regular dental appointments. On top of that, common diseases among the elderly (like rheumatoid arthritis, osteoporosis, and diabetes) can also increase the risk of painful oral problems. Dealing with issues before they come up is substantially cheaper than the alternative: waiting until expensive operations are necessary and then having to pay for dental implants, dentures, or tooth extractions. Dental companies offer affordable plans that allow you to make the visits you need to avoid those expenses down the road, making the cost of maintaining your health manageable.
Dental Insurance Company Review
There are a variety of companies selling dental insurance plans that are available to seniors. With so many companies and options available, it can be difficult to navigate each one to find out what may be most suitable for you at this stage of your life. So, what we have below are a selection of three companies and why they are recommendable to seniors. Each company has its own most attractive reason for why we think it may be most suitable for a senior. You may consider the most attractive reason the most important reasoning behind your decision when selecting a provider.
The three companies that we have evaluated and chosen as our stand-out providers for senior citizens are Guardian Dental, Dentalplans.com and Spirit Dental.
By selecting Guardian Dental, you have access to over 360,000 locations and more than 100,000 dentists. The plans come with the enticing element of flexibility and freedom as with the Guardian Dental Advantage (Gold, Silver and Bronze) plans you can change your dentist as often as you wish whilst with the Dental Health Maintenance Organization (DentalGuard) plan you are also allowed to change your dentist and that will come in to effect on the first day of the next month.
You can find flexibility throughout the whole process of using Guardian Dental. The payment process is a perfect illustration of this, with you being able to make payment via various methods (credit card, debit card, check or bank draft) and there are also numerous options for the frequency of making payments (monthly, quarterly or annually).
For those who decide that Guardian Dental is the right choice for them, there are also no sign-up fees to get started and if you decide later that you wish to cancel, then this process is just as simple, meaning you can have a smooth entry and smooth exit from the plan. Meanwhile, while you are using the service, if you are looking for simple dental services, you can make savings of 35%.
With their Dental Health Maintenance Organization plan, you may be in a position where the plan costs under $10 a month (dependent on your location) and with that, there is no annual maximum, no deductibles, no waiting periods and no forms when you use your primary dental care provider.
Their other option is the PPO plan. This option costs more but you can obtain 35% savings and make use of the huge network. There is, however, a deductible. But with the PPO plan you have the option to use an out-of-network dentist.
Finally, if you decide that Guardian Dental should be your dental plan provider, just check first to make sure that Guardian Dental covers your location as it is available in only 20 states.
Read our Guardian Dental Review
When looking for a dental plan it can often be an arduous mission. With Dentalplans.com they look to take away this problem by providing you a website centred on its accessibility. By coming to their website, you can scour over 30 dental savings plans which include some of the most reputable companies out there, such as Careington, Aetna and Cigna (not an exhaustive list). The website also has other great features as well as ways in which you can do further research and find more information. As well as the slick website, you can always contact their customer service team (AtYourService), who have a great reputation for their service.
One of the other features on Dentalplans.com is that they give you the opportunity to put a figure to the claim made about the savings you can make by having a specifically designed online savings calculator. This can be used to help you work out exactly the financial figure you are saving by enrolling with one of the available plans.
There are numerous plans they offer, covering a wide amount of services. You are in the position to take on dental only plans if you wish, but you are also able to select coverage for other areas of health like vision, hearing, Rx, telemedicine, chiro and wellness. If you do decide to include other areas of health and wellbeing into your plans, you can also receive additional discounts in those areas too.
Signing up to a plan is simple on Dentalplans.com and you are also safe in the knowledge that you will be guaranteed to be accepted. Their plans also advertise no annual limits, no waiting periods and no paperwork. On the off chance that you shop around and find a plan cheaper elsewhere, Dentalplans.com price match, meaning that you will never lose out on the costs. You can also make further savings on costs by making use of the ‘Refer a Friend’ scheme which can earn you additional months for free.
Experience in our lives tells us that finding an opportunity for a positive guarantee occurs rarely, however at Dentalplans.com they offer two! First the 30-day money back guarantee if you wish to cancel early on and then the ‘Pay for Itself Guarantee’ which is, if by the end of the year you have not saved enough based on your plan, then they will give you your money back (excluding the processing fee).
Plans on Dentalplans.com are charged on an annual basis, but they are very affordable with some individual plans starting at as low as $79.95 per year. You can also gain access to savings from 10% – 60%. Just remember with the plans offered by Dentalplans.com, if you do decide to enrol, you are liable for a $20 enrolment fee.
Read our DentalPlans.com Review
When deciding to advertise comprehensive dental plans for the ‘little people of America’, it is obvious that Spirit Dental are looking to find suitable options for everyone, and this includes senior citizens.
There are two types of plan available with Spirit Dental and they have varying degrees of coverage. The Spirit Dental Network plan is designed to be affordable and provide savings. It has a large network of 483,000 access points and 115,000 unique providers. The Spirit Choice Network on the other hand provides more flexibility (you can see any dentist), but if you do choose an in-network provider you can access additional savings. Coverage under this fee-for-service plan can see you reimbursed between 50% – 100% for both usual and customary expenses.
The plans Spirit Dental offer can be paid for on a monthly basis which is perfect if you do not feel comfortable paying upfront an annual fee.
In addition to the monthly payment option, Spirit Dental offer great benefits to their consumers. One benefit is the option to include vision care in your plans for just an additional $7 per month while other benefits that come with signing up to Spirit Dental include, receiving a Wellness Card (a card for prescription discount), entitlement to IHear (this is discounts for hearing care) and access to PetRX (with this you can get great savings on pet prescriptions).
Another unique benefit with Spirit Dental is that they reward loyalty, and this is done by increasing your coverage annually up to an annual maximum of $5,000.
On top of great additional benefits, you can also be certain that you will not be subject to waiting periods and when you look to sign up with Spirit Dental you know that your personal situation is irrelevant as you are guaranteed acceptance.
Plans are available in any state except Washington. Please note, that there is a $100 deductible, however this is a one-off payment that you will not need to pay again for the duration of your time with Spirit Dental.
Read our Spirit Dental Review
Frequently Asked Questions about Dental Insurance for Seniors
Why do dental insurances have a waiting period?
Dental insurance companies have waiting periods after your application is accepted. The purpose behind these waiting periods is to prevent customers from taking advantage of insurance companies by waiting until they need several procedures done before buying insurance and using it to cover their costs. Many plans will make exceptions to this waiting period for procedures like regular checkups. One of the companies featured below maintains no waiting periods for almost any procedure you may need.
How long does it take to get a dental insurance application approved?
Dental insurance companies typically respond to an application within 3 weeks.
What if I need a dental procedure during the waiting period?
It never hurts to appeal your waiting period to your company, although it’s unlikely they would budge. Most dentists, however, are often willing to work with you to establish a reduced rate for in-cash payments or set up a payment plan that you can afford. No matter what, you should never let a waiting period prevent you from preserving your oral health. Don’t hesitate to get the care you need.
Can I stay with my current dentist?
Some dental plans and insurances only cover you if you see one of their pre-approved providers. Ideally those have been gone through a quality check and usually they have negotiated lower prices with them. If you want to stay with your current dentist, make sure that the plan you choose covers it. You can always ask your dentist which plan they accept and go from there.
What is a coinsurance rate?
Coinsurance is the amount or percentage of a procedure that you will have to pay. If your company offers to pay 50 percent of a procedure, you will have to supply the other 50 percent, if they cover 60 then you’ll have to provide 40, and so on. This rate often changes depending on the procedure you’re getting done, and companies maintain their own rates separate from market averages.
What if I expect to need extensive dental work?
You should know the needs you expect to have before you buy a policy. Some companies with extremely low rates will only cover $500 per year in expenses, which will leave you hanging out to dry for the rest of your needed operations. Make the decision as to which company you buy from with that in mind.
Is oral surgery covered by dental insurance?
It depends. Some issues, like wisdom tooth removal, could fall into either medical insurance or dental. Trauma and abscessed tooth treatments typically are covered under medical plans. You should consult your medical insurance to see what they cover before you go looking for dental care, so you know what sorts of things you’ll need covered and what you already have under your medical.
Cost and coverage are the two most important factors to consider when searching for dental insurance companies.
Most of the time you can go out of network to see a dentist you prefer, but it will usually cost you more. If you have a preferred dentist, we recommend calling their office and just ask which dental insurances consider them in-network. Check their prices and think about if it’s worth for you going with them.
Senior citizens often face increasing dental care expenses the older they get. Unfortunately those are mostly not covered by Medicare. We definitely think that signing up with a dental insurance or a dental discount membership is a great way to save money in the long run. Before you choose either, make sure to know exactly what each plan covers and then compare prices.