Types of Dental Insurance Plans for Seniors
While Original Medicare does not include dental coverage, there are other options available to seniors. Medicare Advantage, which is provided by private insurers, often includes dental benefits at varying levels of coverage depending on the specific plan. Insurance companies also sell standalone dental plans.
What Types of Dental Insurance Plans Are Available to Seniors?
Even if you are a Medicare beneficiary and have other forms of health care covered, you will need separate coverage for your teeth. The majority of dental care is not included in Original Medicare, according to the U.S. Centers for Medicare & Medicaid Services. Cleanings, fillings, extractions, dentures and many other items and services are not covered.
Seniors can often get dental coverage through a Medicare Advantage plan. These plans, which are provided through private insurers, always cover all Medicare-covered services and coverage while also covering additional benefits. One of the benefits that is commonly included is dental care.
Insurance companies also typically offer standalone dental plans, which can be purchased separately from Medicare. If you are interested in getting dental coverage, it’s important to do research on the plans available in your area to find the best option that fits both your health and financial situations.
There are several different types of dental coverage plans that are available to seniors. Each of them is structured in different ways from how much they cost to how they help pay for your dental care.
- Preferred Provider Organizations (PPO)
- A PPO dental plan doesn’t require you to choose a primary care dentist, so you have more flexibility in where you get your care. The trade-off for this is higher costs.
- Dental Health Maintenance Organizations (DHMO)
- In a DHMO, you select a primary dentist where you will receive care and who can refer you to specialists.
- Direct Reimbursement Plan
- These plans don’t require you to stay within a network but are typically tied to an employer.
- Discount Plan
- These affordable plans are not technically insurance, but instead offer various savings and discount opportunities for dental care.
- Schedule of Allowances Plan
- This type offers to cover a certain allowance for a service, with you paying anything that goes over that amount.
- Supplemental Dental Insurance
- A type of plan that complements another form of coverage and helps you manage some of the costs of dental care.
- Network Dental Insurance
- A plan that requires you to receive care within a network.
What Does Dental Insurance Cover for Seniors?
What your dental insurance covers will vary based on the type of plan you have. Medicare Advantage plans are available regionally, so your exact coverage options will vary based on where you live.
More expensive plans will also sometimes cover more dental care. Medicare Advantage plans can typically cover checkups and preventive visits, cleanings, dentures and other dental-related services. Other coverage, like major services such as root canals or oral surgery, will depend on the type of plan you have.
Original Medicare may cover some dental care in rare circumstances, like if you have a dental emergency. But the bar for coverage here can be high. For example, a broken tooth, even if painful, would likely not qualify as an emergency.
How to Choose the Best Type of Dental Insurance
There’s no way around the fact that dental care is a major expense for seniors. But dental coverage, whether through Medicare Advantage or a standalone plan, can help make those costs more manageable and affordable.
Having dental coverage can also provide seniors with access to preventive services and routine checkups. This can help you safeguard your health and get ahead of future dental health issues that could become a major expense.
When looking for the dental coverage that is best for you, research your specific health concerns to identify a plan that covers the treatments or services you are most interested in. You can also speak with your dentist about what plans may make the most sense for you.
5 Cited Research Articles
- U.S. Centers for Medicare & Medicaid Services. (2021, December 01). Medicare Dental Coverage. Retrieved from https://www.cms.gov/Medicare/Coverage/MedicareDentalCoverage
- Cigna. (n.d.). Discount Dental Programs. Retrieved from https://www.cigna.com/individuals-families/understanding-insurance/discount-dental-programs
- Humana. (n.d.). Preferred Provider Organization (PPO) Dental Insurance. Retrieved from https://www.humana.com/dental-insurance/ppo
- U.S. Centers for Medicare & Medicaid Services. (n.d.). Dental Services. Retrieved from https://www.medicare.gov/coverage/dental-services
- U.S. Office of Personnel Management. (n.d.). Frequently Asked Questions. Retrieved from https://www.opm.gov/faqs/QA.aspx?fid=fd635746-de0a-4dd7-997d-b5706a0fd8d2&pid=85ca5328-7cb3-47ca-b07b-55f6edaa2fcb