Dental Insurance for Seniors: Exploring the Benefits of Insurance Coverage

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Dental insurance for seniors is an essential kind of insurance coverage for the elderly. Given the high expenses demanded by dental care services like preventive care, minor restorative services, or major dental procedures, seniors might have difficulty finding money to cover all those expenses. As a result, seniors tend to eliminate dental care from their priority list which will then increase their risk of various dental health problems in the future.

Dental insurance helps seniors pay for the needed expenses for dental care instead of relying on their own pockets. There are many dental plan options to choose from, and in this article, we will help you find the right dental insurance policy based on your condition and needs.

Dental Insurance Definition

Dental insurance is a kind of insurance policy agreed upon between the insurance company and the policy holder. Basically, the policy holder pays monthly premiums, and in exchange, the insurance will cover most of the dental care expenses including check-ups, major procedures, and minor procedures. The amount of money paid monthly will depend on the services covered and how long the plan will be in force.

Types of Dental Insurance for Seniors

There are different types of dental insurance plans for seniors. These include the following:

  • Preferred Provider Organization or PPO - In this type of dental insurance, the policy holder will have the option to make use of the network of dentists provided by the insurance company, but the policy holder can still choose their preferred dentists and get paid fees reimbursed. This network of dentists has a contract with the insurance company where they should charge fees to their member patients according to the insurance policy.
  • Exclusive Provider Organization or EPO - This is quite the opposite of PPO wherein the provider options of the policy holder are limited only to the ones provided by the insurance company. If the policy holder decides to choose a dentist outside the policy’s network of providers, the fees paid will not be reimbursed.
  • Direct Reimbursement or DR - As the name suggests, direct reimbursement is a type of insurance plan wherein the patient will pay the dentist directly for whatever service is done Next is that the patient should get a proof of payment or receipt to which s/he should present to the insurance company to process the reimbursement.
  • Dental Health Maintenance Organization (DHMO) - Compared to PPOs, DHMO policies have lower monthly premiums and zero annual deductibles. However, The policy holder might still need to pay co-payments as listed on your Schedule of Benefits.
  • Indemnity Plans - Also called the traditional plan. Indemnity plans give the policy holder the option to choose his/her preferred dentist and claims paid by the insurance company are based on the type of service rendered. Usually, this type of plan has a maximum allowance for each dental procedure.
  • Discount Plans - In this type of dental insurance plan, the insurance company contracts with the network of providers to offer discounts to the policy holder. Though discount plans are not entirely an insurance policy where the patient signs a contract with the insurance company, it is still one of the preferred dental plans availed by employers for their employees.

Things to Consider Before Availing Insurance

Now that you know the different types of dental care insurance, you may now have an initial assessment of what type best suits your needs. Before deciding though, you should keep in mind the following:

  1. Affordability - One of the important aspects to consider first is what insurance policy can you afford. Generally, HMO plans have cheaper monthly premiums than PPO plans, however, they might still require you to pay co-payments based on the contract signed by the partner dentist and insurance company. PPO plans, on the other hand, have higher monthly premiums, but wider coverage.
  2. Preferred Dentist - Do you have a preferred dentist? You might want to choose an insurance plan where that can give you flexible options when choosing providers. PPOs usually give their policy holders the option to choose their own dentist without affecting the benefits they receive from the plan.
  3. Plan coverage - In finding dental insurance, you should also assess what dental services are covered by the insurance policy, especially if you need major dental procedures.
  4. Insurance limits and waiting periods - Some insurance companies have long waiting periods and annual cap limits. While this is not a problem for seniors with enough savings and stable income, seniors with a limited budget for dental procedures may have a hard time covering out-of-pocket expenses while waiting for their claims.
  5. Group coverage eligibility - Check whether you are eligible for group coverage plans like AARP, Affordable Care Act, Medicare, etc. Becoming part of a group coverage will give you more benefits and discounts compared to individual dental insurance.

Top Dental Insurance Choices

The following are some of the top choices of seniors when it comes to dental insurance.

Cigna

Most dental insurance policies in Cigna come with affordable premiums, no annual deductibles, and no co-payments. It also covers 100 percent of preventive dental care services like regular check-ups and cleaning. Cigna is a good option for seniors who are looking for wide coverage and affordable dental insurance. You can also monitor your payments through their official site.

Aetna

One of the well-known insurance companies across the US. Like Cigna, Aetna offers affordable insurance policies. With as low as 20 to 31 dollars a month, you’ll get wide coverage on various dental procedures. You should get prepared for long waiting periods though.

Delta Dental

This company is one of the most trusted dental insurance companies in the US. Delta Dental both offers HMO and PPO plans. Also, with over 150,000 networks of providers, policy holders have many dental clinics to choose from. The company also offers affordable premiums ranging from 50 dollars to 154 dollars a month depending on the type and coverage of the plan.

Guardian

Guardian is known for its affordable policies, discounts, and coverage options. In fact, It is one of the insurance companies with the highest rating and customer satisfaction. Policy holders will also benefit from zero deductibles. Moreover, Guardian does not include waiting periods for preventive care services. Major dental procedures, however, may include a 12-month waiting period.

Final Word

Given the natural process of declining health during our senior years, It is pretty common to encounter dental health problems. This means that we may have to spend a large sum on dental care. Fortunately, Availing of dental insurance helps seniors pay for their dental care expenses other than relying on their own savings or income.

Opting for dental insurance should come with a thorough assessment, wherein one should consider factors such as affordability, coverage, limits, eligibility, and needs.

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