Dental care is important at any age, but you may be surprised to learn that Medicare doesn’t cover most dental care for those eligible. Even some Medicare Advantage Plans can leave expensive gaps in coverage. A standalone dental insurance plan can help reduce overall costs — here’s how you can choose the best dental insurance for seniors.
Quick Look: The Best Senior Dental Plans
- Best Overall: Delta Dental (AARP)
- DentalPlans.com – Learn more
Dental Insurance for Seniors: Overview
When you leave the workforce to enjoy a well-earned retirement, often your medical and dental coverage is left behind as well. Medicare is available for most seniors at age 65, but most dental care and dental procedures, like cleanings, fillings, tooth extractions or dentures, aren’t covered by Medicare Part A or B.
There may be some rare exceptions in cases where other medical needs overlap with dental care. Medicare Part C, also known as Medicare Advantage Plans, may cover some dental care needs but benefits vary by insurer. Many times, it’s easier for seniors to purchase a dedicated dental insurance plan that clearly defines what’s covered.
Types of Coverage Offered
When searching for dental insurance, you’ll probably encounter some dental discount plans as well. These plans aren’t insurance in the strict sense of the term, but they can accomplish a similar goal in managing dental care costs by offering discounts on dental care. Some dental discount plans even offer free cleanings and free check-ups, making them a viable alternative to dental insurance.
Dental insurance can have its limitations as well — but can still be a money-saving move. The biggest limitation is the annual maximum, which can be a confusing term.
For health insurance, the annual maximum refers to your out-of-pocket costs. The annual maximum cost refers to the maximum amount the insurer will pay each year. Often, the annual maximum is capped between $1,000 and $2,000.
It’s common for dental insurance plans to enforce a waiting period for some types of dental care. You often can’t purchase dental insurance on Tuesday because you have a toothache and then get a filling on Wednesday. You may have to wait up to 6 months for your coverage to pay for the filling. Other procedures may require an 18-month waiting period.
Most plans include routine care, like check-ups and cleanings at no charge or with a minimal cost to you. You’ll find the following dental procedures covered by many dental insurance plans, although coverage amounts can vary and some plans exclude coverage for certain procedures altogether:
- Preventative care
- Root canals
- Tooth extractions
- Prosthodontics (dentures)
Most dental insurance plans use a 100-80-50 coverage structure, which means the plan covers 100% of the cost of basic services, like cleanings; 80% of the cost of basic procedures, like fillings; and 50% of the cost of major procedures, like crowns, oral surgery or extractions. The remainder of the cost for partially-covered procedures is paid by the patient as well as any costs that exceed the annual maximum.
Depending on the type of dental insurance plan you choose, your monthly cost can range from $10 per month up to $60 per month. A cost of around $30 per month is more common. Your age, the number of people covered and the type of plan you choose are all factors in the cost of coverage.
For dental insurance plans, you may have the option of a preferred provider organization (PPO), which gives you more freedom to choose your dentist, a health management organization (HMO), which uses specific dental care providers to help keep coverage costs low or an exclusive provider organization (EPO), which has fewer restrictions than an HMO and still offers cost savings when compared to a PPO.
Dental discount plans, which are not insurance, often cost between $10 to $20 per month for individual coverage and offer discounts on dental procedures ranging from 10% up to 60%, depending on the service performed.
An annual commitment is often required for both dental insurance plans and dental discount plans. An annual deductible can also apply for some plans.
How to Get Covered
Getting started with a dental insurance plan or a dental discount plan is easy. In some cases, you may be eligible for subsidies when purchasing dental insurance if your income is less than or equal to 400% of the federal poverty level. If this is the case, be sure to check your options on the Marketplace or your state’s healthcare portal.
The biggest hurdle for those who need coverage right away is the waiting periods that are common for many procedures. Generally, you can expect nearly immediate coverage for basics like exams or cleanings. Also, some insurers specifically exclude coverage for some pre-existing conditions.
In most cases, you can apply online and have a policy almost immediately, although some plans may have a short waiting period before the policy is effective. Unlike health insurance, you can purchase dental insurance at any time without date restrictions. Getting covered is the easy part. If you choose a plan that requires referrals or limits the coverage to in-network providers, that’s when your plan may require a bit more work.
The Best Dental Insurance for Seniors
Dental insurance options for seniors parallel many of the options available for other adults. However, overall costs and out-of-pocket costs can be a bigger consideration if you have a fixed income or are concerned about making retirement savings last.
What to Look for in a Company
Choosing the best dental insurance company and plan for you depends on your priorities, but here are some common considerations that can affect most people buying dental coverage:
- Network size or dentists included in the plan: If you have a favorite dentist, consider plans that include your dentist. Network size can also be a consideration because a larger network often provides more local choices for dental care.
- Affordable premiums: It’s possible to spend up to $80 per month or more for dental insurance. Learn what’s covered by the plan before buying. It’s possible that similar benefits are available from another plan with lower overall costs.
- Annual maximum: The annual maximum is the most your plan will pay for your coverage in a year. With low maximums, it can be easy to use all your coverage with a single procedure such as a crown. Higher maximums are generally better.
- Network type: Whether you opt for a PPO, HMO or EPO, the type of plan you choose can make a difference in how convenient your plan is to use and the monthly cost involved. HMOs are less expensive but limit coverage to in-network dentists. PPOs provide the most freedom in choosing dentists but tend to cost a bit more.
Best Overall: Delta Dental (AARP)
Available to AARP members, Delta Dental has 2 PPO dental insurance plans available in most states with a dental discount plan also available in select states, like Florida. The PPO plans allow the freedom to visit any dentist, which is great for traveling seniors.
The dental discount plan, called DeltaCare USA, requires you to choose a primary care network dentist. A manageable annual deductible of $40 or $90 applies to PPO plans, depending on which plan you choose.
Annual maximum coverage is either $1,000 or $1,500, and again, depends on plan choice. Delta’s PPO Plan A is the premium plan and offers free cleanings and exams as well as a lower annual deductible and a $1,500 annual maximum benefit.
A well-known provider of Medicare Advantage Plans and many related services for seniors, Humana also offers a range of dental insurance plans.
We found a range of plans priced as low as $7 per month for individuals who buy a discount plan up to about $45 for Humana’s Complete Dental PPO, with a few options in between.
Expect a large network of participating dentists in most areas. PPO plans offer the freedom of choosing your own in-network or out-of-network dentist, but costs for services can be higher when choosing out-of-network dental care providers.
Routine cleanings and exams are free with most Humana plans. Some procedures, like dentures or root canals, are only covered by discounts on less expensive plans but are covered at 50% after the deductible on premium plans.
Another well-known provider of Medicare Advantage Plans, UnitedHealthcare offers standalone dental insurance plans as well, with hearing coverage included as an extra and the option to add vision care coverage, which also isn’t covered by Medicare Part A and B.
Monthly pricing can be a bit higher than with some competitors but some plans offer preventative care with no deductible and the annual maximum can be as high as $2,000, among the highest coverage options you’ll find.
Many dental insurance plans enforce a waiting period for several types of services but UnitedHealthcare’s plans offer no waiting period for routine services like cleanings or exams and even for major dental work like crowns and root canals.
Expect coverage to start with a smaller percentage for some services but which will increase over time. UnitedHealthcare’s nationwide network includes over 100,000 dental providers.
Plan availability can vary but in many areas, you might find as many as 8 dental insurance plans from Ameritas, ranging from under $30 per month up to $60 per month. Many top-level plans include coverage for items like orthodontics, which may not be a priority for many seniors.
Lower-level plans still provide standard coverage for preventative, basic and major services, following a familiar 100-80-50 coverage percentage formula. The best savings are found with in-network services and annual maximum benefits range as high as $2,000.
While not a dental insurance provider, DentalPlans is a leading online portal for choosing dental discount plans. In most areas, expect to find a wide choice of plans available with discounts ranging from 10% up to 60% for most dental services.
Prices for preventative care range from free to about $20 per visit, depending on the plan you choose. The variety of plans available ensures that you’ll find plans that support several great dentists in your area. With a dental discount plan, you pay a fixed (discounted) price for each service. A processing fee may apply when purchasing your plan.
Choose the best dental insurance for you
Plan availability can vary by area — particularly with less-expensive HMO plans, so you’ll want check to see which plans are available near you. Generally, the most affordable plans with regard to premium are dental discount plans. The caveat is that you pay the discounted price for services out of pocket.
Depending on the amount or type of work that needs to be done, this can make a less expensive plan overall. Dental insurance plans aren’t subject to the same rules as traditional health insurance and many plans require a one-year commitment. Be sure to familiarize yourself with coverage and restrictions before choosing a plan.