Matching Dental Plans to the Needs of Seniors

May 7th 2016

According to the National Association of Dental Plans, 97 percent of dental insurance policies are provided by employers. Unfortunately, this has left retired seniors with fewer options for coverage. Yet, if you’re a senior, your dental needs could actually be greater now than when you were younger and working. Fortunately, today there are many more options available to seniors than there were in the past, but you need to do some homework, lots of comparisons and a little bit of math in order to find the dental program that is best for you.

Know Your Dental Health Needs

As a senior, it's important to anticipate the types of dental services you might need in the near future. If your dental health is good, you may just be on a preventive maintenance schedule of regular cleanings and exams twice a year.  On the other hand, if your teeth and gums have not held up as well to the test of time, you might need periodontal surgery for gum disease or tooth replacements due to extractions. The life expectancy of fillings is only about 10 to 15 years, so you may have fillings that are failing or broken, which makes them good candidates for crowns. It never hurts to check with your dentist to get a clearer picture of your dental health needs.

Traditional Dental Insurance Plans

Before considering a dental program, you'll want to understand the differences between various types of available plans. A traditional dental insurance policy will have monthly premiums and a yearly maximum payout that is usually around $1000 to $1500.  Preventive services are often covered at 100 percent, with 80 percent coverage for fillings and other basic services. Major services such as crowns, dentures and bridges may only be covered at 50 percent, and there is usually a yearly deductible of around $50 applied to basic and major services.  Premiums for this type of comprehensive coverage can range between $500 to $600 a year for an individual.  A policy that only covers preventive services could cost about $250 a year. Many of the large dental companies such as United Concordia, Aetna and United Health are selling these types of individual policies on the Internet.

Besides the high monthly premiums, other disadvantages of insurance programs for seniors may include considerable out-of-pocket expenses if major services are necessary, waiting periods and pre-existing provisions limiting certain treatments. On the plus side, you can purchase a plan where you do not have to go to a “network” dentist; you can continue going to your own dentist and still be eligible for benefits. However, if the plan does have a network of providers, you would save more money by going to a dentist within the network.  

Dental Savings Plans

While affordable individual dental insurance policies may be limited, the one type of plan that is becoming more prevalent in the marketplace, as it's a good option for many seniors, is the dental savings or discount plan. Features of this type of plan include:

  • A low monthly or yearly membership fee
  • Appointments with reputable dentists who participate in the program
  • A discounted fee (10 to 60 percent off the dentist’s regular fees) for any dental services

There are no claim forms to deal with, deductibles or yearly maximum allowances, and no pre-existing exclusions or waiting periods for most plans. But, you will have to change providers if your dentist is not in the network, and depending upon your location, some networks are sparse.

Examples of savings plans include, which recently started in California but is expanding its network nationwide, and, which has been in around since 1999 and represents more than 30 leading savings plans with networks consisting of more than 100,000 dentists throughout the country. Discount plans are becoming more popular because the savings surpass the cost of the plan, and the membership fee often includes everyone in the household.

With the right dental plan in place and a healthy dose of knowledge under your belt, selecting the best dental plan for your needs is a breeze. 

Dental Plan Shopping Tips

  • Shop around. Programs and their costs vary, so it is important to look for one that not only fits your needs but also your pocketbook.
  • Make sure that the program has understandable disclosure information and read it carefully.
  • Check that there are dentists and specialists in your area that you would be willing to go to for treatment if your dentist doesn’t participate in the network. But before switching, ask your dentist if he would be willing to be a network provider.
  • Choose a plan that is a member of the National Association of Dental Plans or the Consumer Health Alliance, and check out the NADP’s site to get information about what you should be looking for to avoid a fraudulent plan.

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