Are you seeking information about dental insurance for seniors over 65? These plans are specifically designed to address the unique needs of senior oral health and fill the gap in Original Medicare coverage. Read on for information about the coverage and cost of dental insurance plans for seniors.

Dental Gap in Original Medicare

Because dental is not included in Original Medicare (unless medically necessary) or Medigap supplement plans, seniors must look elsewhere for dental coverage. So, dental insurance for seniors on Medicare can seem like a chore. But getting dental insurance when you’re using Medicare isn’t difficult, limited, or expensive. In fact, there are two different paths to take in order to find inexpensive coverage options.

First, you could enroll in a Medicare Advantage plan. Many Medicare Advantage plans include vision, dental, and prescription drug coverage. All of these benefits are coordinated together, so any premium costs will be included in your low (or non-existent) Medicare Advantage premium. Just be aware that dental benefits are usually limited to cleanings, exams, and bitewing X-rays. If you are looking for more comprehensive coverage, you may want to add on a stand-alone dental plan.

Alternately, you could purchase a stand-alone dental plan. Stand-alone dental insurance plans for seniors are sold by private insurance companies and don’t need to be coordinated through Medicare. They will have a separate premium, but stand-alone plans can be considered affordable for the coverage they provide.

What Do Plans Designed for Seniors Cost?

If you enroll in Medicare Advantage, your plan may already include dental coverage. Otherwise, the cost of stand-alone dental insurance plans for seniors over 65 will depend on the level of coverage chosen. Usually, monthly premiums will be about $19-39.*

What Does Dental Insurance for Seniors Over 65 Cover?*

The best dental plans for seniors will cover a plethora of services. The level of coverage (100 percent, 80 percent, 60 percent, or 50 percent) will depend on the type of service provided and the benefit level you have chosen (basic or premium). Here are some examples of services that can be covered.

Type I Services

  • Prophylaxis
  • Oral evaluations
  • Bitewing X-rays
  • Vertical bitewings
  • Diagnostic casts

Type II Services

  • Intraoral films, extraoral films and panoramic film
  • Amalgam, primary or permanent and resin-based composite
  • Palliative (emergency) treatment of pain
  • Fixed partial denture sectioning
  • Local anesthesia
  • Inhalation of nitrous oxide
  • Occlusion and analysis and occlusion adjustment

Type III Services

  • Inlays and onlays
  • Recementing
  • Crowns; cast posts and core buildups
  • Pin retention in addition to restoration
  • Sedative fillings
  • Endodontics
    • Pulp caps; therapeutic pulpotomy; pupal therapy
    • Root canal or endodontic therapy
  • Oral Surgery
    • Extraction of an erupted tooth; removal of impacted tooth
    • Tooth transplantation
    • Alveoloplasty
    • Removal of cyst/tumor 1.25cm and greater
    • Incision and drainage of abscess
  • Prosthodontics
    • Complete and partial dentures
    • Adjustment and repair of dentures
  • Periodontics
    • Gingivenctomy/gingivoplasty
    • Gingival flap procedure and osseous surgery
    • Soft tissue graft procedures
    • Periodontal scaling and root planning
    • Full-mouth debridement to enable evaluation and diagnosis

These are simply examples of services covered by dental insurance plans for seniors. Be sure to check your dental policy for which, and how much, services are covered.

What About Dental Discount Plans?

Although discount plans are also sold by private companies, they are not insurance plans. There are no copays, coinsurance, or deductible amounts. That also means that there are no pre-negotiated rates or free yearly checkups and cleanings. A participating dentist simply agrees to offer discounts (often a percentage off from the total price) for certain medical services. Then, seniors who choose discount plans will pay their dentist directly for the cost of services (after the discount).

Discount plans can be a good alternative for dental insurance because:

  • They are inexpensive.
  • There are no deductibles.
  • There are no waiting periods.
  • There are no limits to how often you can visit or change your dentist.

These plans vary in coverage, but can include:

  • Cleanings
  • Checkups
  • X-rays
  • Fillings
  • Crowns
  • Dentures
  • Root Canals
  • Extractions

Discount plans can also include other things, such as vision and prescription coverage.

Where to Find Dental Insurance for Senior Citizens

If you’re looking for dental insurance for seniors over 65, start with HealthMarkets. We represent insurance companies with plans specially designed for seniors, and we have licensed health insurance agents available by phone or in person. Just call us at (800) 488-7621 or find an agent near you today.

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References

* Premium initial quote for basic and premiere benefit level. Actual benefits and rates vary by state. The supplemental benefits referenced are taken from PPO Dental Policy Form CH DEN PPO TX 417, or its state variation which is underwritten by The Chesapeake Life Insurance Company. Administrative offices located in North Richland Hills, TX. Product availability varies by state. A complete list of benefits, exclusions and limitations is available upon request. Please contact a licensed agent and refer to the Policy.

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