Dental insurance for seniors: 6 smile-friendly tips to help you pick a plan

Looking for dental insurance for seniors?

If you want to keep your teeth happy as you age, you know the drill…

• Brush and floss daily
• Visit a dentist for regular checkups, cleanings, and oral healthcare needs

That makes sense, right? Here’s the thing…

• An estimated 56% of adults age 65 and older enrolled in Medicare don’t have dental insurance for seniors.¹
• Dental care in the U.S. costs an estimated $165 billion a year, and most of that is paid by private dental health insurance plans.²

Not sure where to find a plan, how much it costs, or what dental insurance for seniors covers?

These are common reasons older adults avoid getting dental insurance for seniors. So let’s change that.

In this article, you’ll learn more about dental insurance for seniors, including:

• 3 types of plans + discount plans
• How dental insurance plans work
• What dental insurance for seniors covers
• No insurance? Here’s what you can expect to pay for dental care
• 6 smile-friendly tips to find dental insurance for seniors

3 types of dental plans + discount plans

If you’re looking for dental insurance for seniors, there are three common types of plans to choose from. You’ve probably heard of discount dental plans, but they’re a little different than insurance.

Here’s a quick look at three types of dental insurance plans and discount plans.

1. Dental Health Maintenance Organization plans

DHMO plans typically require you to choose one dentist or dental office to coordinate all of your dental services.³

• You don’t have the option of choosing a dentist outside the network.
• DHMO plan pays the dentist a fixed price to perform specific types of services.
• And typically there’s no waiting period on all covered services.
• This office will perform all your basic dental work and will refer you to a specialist if needed.
• As long as you stick with your chosen dentist and their referred specialists, the plan will usually provide extensive coverage.
• If you get dental care outside the DHMO network without a referral, you’ll typically pay 100% out of pocket for services.

If you’re looking for dental insurance with no waiting period, there’s one other way you can save money.

2. Dental Preferred Provider Organization plans

A DPPO plan typically consists of a network of selected dentist offices.³

• You’re free to visit any dentist within this network.
• If you go outside of the selected network with a DPPO plan, you can still expect to have your services at least partially covered by the plan.

3. Indemnity plans

Indemnity plans for dental care (sometimes called fee-for-service plans) breaks down the percentage covered by the plan based on the type of service.³

For example:

• A routine cleaning might be covered at 90%.
• A root canal might only be covered at 50%.

4. Discount dental plans

This isn’t dental insurance. But some people use discount dental plans as an alternative to dental insurance for seniors.³

However, with discount dental plans, it’s important to know there are no:

• Co-pays
• Claims
• Deductibles
• Referral requirements
• Forms to fill out

Instead, you’ll be able to pick from a list of participating dentists who agree to provide specific dental services at fixed prices and discounted rates.

And there’s no waiting period. You just make an appointment with a dentist whose part of the plan, get the dental care you need, and pay the entire discounted rate.

Dental insurance for seniors: How it works

Wondering how dental insurance for seniors works?

It’s similar to typical insurance that covers and variety of services at different rates that might cover:⁴

• 100% of routine care such as checkups and cleanings
• 80% percent of the cost of fillings, root canals and other such procedures
• 50% of the cost of more advanced services such as bridges or crowns

Many providers that offer dental insurance for seniors use a similar model. However, there are a number of variables that may differ from one plan to the next.

It’s important to carefully consider each of these variables and identify the ones that are most or least important to you, your budget, and your dental needs.

Here are a few more helpful tips to understand dental insurance for seniors, how it’s organized, how much it costs, and when you might have a waiting period.

Networks

A network is a group of selected dentists that have agreed to contract with the insurance company. The level of coverage can depend on whether you use a dentist inside or outside of the plan’s network.

Monthly premiums

The monthly premium is the amount you must pay each month to remain enrolled in the plan that provides dental insurance for seniors.

Deductibles

A deductible is the amount you must first pay out of pocket before the insurance (or a certain percentage of the insurance) kicks in.

Copay/coinsurance

Copay and coinsurance are both forms of out-of-pocket expenses you’re likely to incur when you visit the dentist.

• A copay is a flat fee (such as $15 for a teeth cleaning visit).
• Coinsurance is a percentage of the total amount of the service (such as 20 percent of the cost of the teeth cleaning).

Out-of-pocket maximums

An out-of-pocket maximum is the most you will pay out of pocket for all dental services in a given year.

Once you reach this limit, the insurance will cover the remainder of eligible dental costs for the rest of the year.

Waiting periods

Most dental insurance plans will come with a waiting period where certain procedures may not be covered for a specific amount of time.

• For example, coverage for a root canal might not be available until you have had the plan for six to 12 months.

Not all dental insurance plans require a waiting period. But it’s a way for the insurance company to protect itself from a customer who signs up for the plan, has a root canal performed and then drops the plan after the procedure.

What does dental insurance for seniors cover?

Most dental insurance plans cover a few basic and major services. These can include things like:

• Cleanings and exams. It’s not uncommon for a dental insurance plan to entitle you to one or two cleanings and/or exams each year.
• X-rays. Basic x-rays are often covered by insurance while more advanced x-rays may require a greater out-of-pocket expense.
• Fillings and extractions. Having a cavity filled or a tooth pulled can often be done with just a copay or coinsurance.
• Standard repairs. Procedures such as root canals, bridges and crowns are partially covered by many dental insurance plans.

Some dental insurance plans might extend coverage or partial coverage for more advanced services such as:

• Oral surgery. Common oral surgeries include teeth removal, the drainage of infections and gum tissue biopsies.
• Orthodontics. This can include new braces, retainers and care.
• Periodontics. Periodontics involves the treatment of gum disease, infections, and lesions.
• Prosthodontics. This can include dentures and bridges.

No insurance? Here’s what you can expect to pay for dental care

If you don’t have dental insurance for seniors, here’s what common dental-care services cost on average:⁵

• Teeth cleaning: $200
• Tooth filling: $157 to $344
• Braces: $5,000
• Wisdom tooth extraction: $99 to $340
• Dental crown: $800 to $1,700
• Root canal: $500 to $1,500

Disclaimer: This is just an example of average costs for common dental services. Prices may vary depending on provider and location.

6 smile-friendly tips to find dental insurance for seniors

In most cases, Medicare doesn’t cover dental services for seniors for routine care.⁶

Dental insurance for seniors is important to consider, because it can save you money on:

• Preventive dental care like routine cleanings
• Other dental-care procedures and services you may need to restore your teeth

So how do you find dental insurance that works for you?

Here are six smile-friendly tips to help you pick a plan:

1. Anticipate your dental needs

You can start by answer some basic questions, like:

• How often do you find yourself visiting the dentist?
• And when you do, what services are typically needed?
• Has your dentist warned you about any developing problems with your teeth?
• Are you taking any medications that may affect your oral health?

Don’t just think of the services you need now, but think of the care you may need in the future.

2. Determine your budget

How much will it cost? You need to find a dental insurance plan that meets your needs and your budget. Here are a few things to consider:

• How much can you set aside every month to pay premiums?
• How much room do you have for out-of-pocket costs?
• Would a discount plan be better suited for your financial situation?

3. Get quotes

It takes just a few minutes to request dental insurance quotes.

It’s a great starting point to help you compare plans based on the cost (monthly premium, deductible, copays/coinsurance), as well as the amounts of benefits provided.

4. Know the details

Read the details of each plan that appeals to you, or have a licensed dental insurance agent explain the details to you like:

• Waiting periods
• Deductibles
• Prescription drug coverage

5. Get coverage before you need it

Because of waiting periods and plans that may not cover pre-existing dental problems, it’s wise not to wait until you’re in pain to enroll in dental coverage.

6. Ask questions

Before you pick a plan and start paying a monthly premium, ask a few more questions to make sure it’s right for you, like:

• What do customer satisfaction ratings for the dental insurance plans you’re considering say?
• Does the plan have a positive history with the Better Business Bureau?
• Ask people you know about what they like and don’t like about their dental insurance plan.

Looking for dental insurance for seniors?

If you want to make choosing a dental insurance plan a little easier and compare plans, premiums and services, we can help. Just give us a call at (800) 827-9990 to speak to a licensed insurance agent, or find an agent in your area.

Disclaimer: This article contains information that is compiled by HealthMarkets Insurance Agency . HealthMarkets Insurance Agency does not represent all the information provided are statements of fact.