It is a far too common situation. You enroll in Medicare and have your medical and health needs covered. You feel good. Finally, you made a decision about Medicare. What about dental coverage? Your teeth matter, right? We all know when our teeth and gums hurt, everything hurts! Yet, Medicare and nearly all Medicare Advantage and supplement plans do not cover dental needs. If they do, they usually cover preventative care only. What will you do about fillings, bridges, and crowns? You are on a fixed income. Luckily, we at My Family Life Insurance have many and affordable coverage solutions when it comes to your dental needs. In this article, we discuss our best dental insurance for seniors.
Note: many websites tout “the best”, but many of these websites have information that is misleading. For example, many websites illustrate discount dental plans as insurance. Discount dental plans are not insurance. Be careful what you read. Additionally, many carriers fall into the “sameness” category. With the exception of a few differences, they are all the same. We discuss several unique dental insurance plans for seniors.
Best Dental Insurance For Seniors
Let’s cut to the chase. Here are our top picks for dental insurance for seniors. Why? The following strikes the right balance of premiums, value, and uniqueness. Our goal is to illustrate plans that pay for your dental needs and minimize out of pocket costs. Not ones that are costly and won’t cover much.
As we indicated earlier, if you search on Google, you will see other websites touting their “best” dental insurance. All I can say is that what you see may not be totally true. For example, many websites tout the “best dental insurance” only to show and illustrate discount dental plans. Again, discount dental plans are not insurance, and websites stating so is grossly misleading. Be careful.
Ultimately, the “best” dental insurance is the one that pays your dentist and minimizes your out of pocket. It is that simple. We outline our “best” here. Will they be the “best” for you? Maybe. Maybe not. Everyone’s needs are different. But, I think the following gives you a great start. If the following seems confusing, don’t worry. You can always refer to our article on how to understand your dental insurance if you need to learn the basics. Or, better yet, contact us. We can help for sure.
The dental insurance plans we like below are in no particular order.
Mutual of Omaha Dental Insurance
No other website will have Mutual of Omaha on their “best” list. Why not? They boast 375,000 dental provider locations. Mutual of Omaha requires all of these providers to charge at their negotiated insurance fee. In other words, a lower out of pocket cost for you.
They have 2 plans available: a “protection” plan and a “preferred” plan. The protection plan, in my opinion, is the better option. Here are the particulars on the protection plan.
The protection plan is one of the lowest premium plans available. Of course, nothing is perfect, and there are some downsides. One is that there is a flat, annual $100 deductible on all services. Another is the waiting period of 12 months on major services. Then, there currently is a maximum cap on implants. I am not so sure if this is a downside, however, as many insurance carriers do not cover implants.
They have no waiting periods on preventative and basic services, so that is good. With basic services, their coinsurance is 50% whereas other plans are at 80%. Is this a major deterrent? I don’t think so, unless you like to eat candy a lot and not floss or brush your teeth.
Let’s briefly talk about the preferred plan. In my opinion, it is not very good. It is a $1,500 plan and much more expensive. Competitors have comparable plans that are less expensive, and we describe those next.
Mutual of Omaha dental insurance is currently not available in Massachusetts, New York, Virginia, or Washington state. So, if you live in one of these states, no worries. Other great dental insurance options exist.
I think Ameritas is an often overlooked dental insurance carrier. They don’t have brand recognition like Mutual of Omaha, Humana, United Healthcare, etc but they have some awesome plans.
They are available in nearly all states (even New York and Washington state). At last count, there were over 400,000 providers in their network. Most states have 4 plans available. Currently, these plans are as follows:
-Two in-network plans that utilize discounted insurance fees. In-network plans allow you to save more money. Who doesn’t want to save? Remember that Ameritas requires the dentist to charge the in-network insurance fee. You can go to an out of network dentist, but your cost-sharing will be much greater. The two in-network plans include a $1,000 annual benefit plan and a $2,000 annual benefit plan.
*Two PPO or “out-of-network” plans. These are also $1,000 or $2,000 annual benefit plans. These plans allow you to go to any dentist (seriously). If you go to an in-network dentist, the dentist still charges you the contracted insurance fee. Charges are handled differently for out-of-network dentists. Instead of the in-network fee, however, Ameritas will pay your dentist the UCR fee. UCR fee means “usual, customary, and reasonable”. Think of it like a dentist’s “retail” fee. Ameritas’s percentile on the UCR is 80%, which is on the higher end of most carriers.
There are many benefits to Ameritas. First, they have immediate coverage for all services. Yes, even for major services like a root canal. They also have a low annual deductible of $50 which in most states applies to basic and major services only.
Ameritas’s PPO plans are beneficial people who see dentists who don’t accept insurance or are out of network.
Spirit is the marketing name. These plans are administered by Direct Benefits but are underwritten and claims paid by Ameritas. You might think, “John, what are these? The same plans?” No, they are not. The plans offered under Spirit have different, significant features although there are many similarities. They belong on our best list because of their uniqueness and backed by Ameritas.
What are some of these significant differences? Well, for starters, there is a lifetime deductible of $100. Or course, that is on all services. But, once it’s done, it is done!
Secondly, some of their plans have higher coinsurance amounts paid by Ameritas. That is nice. For example, Ameritas pays 65% coinsurance on major services on their $3,500 annual benefit plan. That is great!
Finally, they have some unique, alternative plans that you won’t find anywhere else. For instance, they have a couple of “step-up” plans where the plans start with a relatively low annual benefit in the first year. The annual benefits increase each year until the maximum amount in the 3rd year. My favorite is one that starts at $1,200 in the first year, $2,500 the second, and $5,000 in the third year. No other carrier offers that.
They also have a flat $3,500 annual plan. Additionally, all of their plans offer 3 cleanings per year.
Here is the breakdown of their “step-up” plan. If you are looking for a quality plan with a higher than normal annual benefit, this one is potentially for you. Moreover, this “step-up” plan is affordable.
Even if you don’t opt for their “step-up” plan, they offer some affordable plans in your area.
Humana & Cigna
We lumped these two households names together. Why? Well, in our opinion, there is a lot of sameness between them and others. Yes, that is right. While they might have good networks, they are usually higher-than-normal premiums for average benefits. There are some features that are worth considering, though. That’s why we included them here.
First is that both will allow you to have an immediate benefit on basic and major services if you have had continual dental insurance. That is a plus; however, I have found that seniors who took care of their teeth and whose dentists said there was no major concern did fine with a better plan from Ameritas. Otherwise, there is a 12-month wait.
Humana offers a one-time deductible on a couple of their plans. However, these plans are a little bit pricey, in our opinion. Their plans also don’t go beyond $1,500 annual benefit.
Both Humana and Cigna offer “value” plans. These are true in-network plans. You need to specify a primary dentist and all work must be done in the network. So, if you need to see a specialist, even if the closest one is 40 miles away, that is the one you have to see. These plans are usually cheap with no annual maximum and no limit on services.
Although we are not contracted with them, Physicians Mutual does have a couple of features that stand out. Their plans have no deductible or no annual maximum. This may sound like the best thing since implants.
Consider this, however. Do you know who they use for claims administration and network? That is right. Ameritas. That says something about Ameritas, doesn’t it? You may think we are drumming the Ameritas beat. Not so. We are simply pointing out that Ameritas is a solid dental insurance carrier. We always operate in your best interest.
Their plans tend to be higher cost on average than a $2,000 annual plan or even one of Spirit’s “step-up” plans. They also only operate in a handful of states. Their plans have a 3 month waiting period on basic services and 12 months on major services. As we said, no plan is perfect. However, Physicians Mutual offers some uniqueness with no deductible or annual maximums. These options can potentially help seniors save on their dental insurance costs.
Combination Dental Vision Hearing (DVH) Plans
Many websites have inaccurately touted theses as the best thing since sliced bread. Honestly, in my opinion, they used to stink. However, they are better now since 2 of them have introduced a dental network. Remember, going to an in-network dentist ultimately saves you money.
Some seniors like to have an “all in one” dental insurance plan which not only includes dental coverage, but also includes vision and hearing. Hearing coverage can be especially important since, currently, no stand-alone hearing insurance exists. Moreover, Medicare plans usually do not have good hearing coverage.
Before we get into the two we like, these plans are useful if your dentist does not take insurance or if you need secondary dental insurance. Neither one of them coordinates with other dental insurance, although you may want to check, if you desire to, how your other insurance coordinates.
Manhattan Life DVH
The first plan we like is from Manhattan Life. You can use any dentist, although they use the careington dental network.
You can select an annual benefit of either $1,000 or $1,500. Think of it as a pot of money that gets used throughout the year and then filled up again every January 1. You can use this money for your dental, vision, and hearing needs.
The plan pays based on the contracted insurance rate if you see an in-network dentist and the UCR fee if your dentist is out of network. The coinsurance amounts are as follows:
Manhattan Life allows you to have another dental insurance. They don’t care if you have other dental insurance. Even a dental discount plan can work well here. Using the above example, if the dentist routinely charges $200 for cleaning, but per the discount plan contract, charges you $100, you will have a net cost of $10.
For a 65-year-old person entering Medicare, the indemnity plan starts at around $35 and $45 per month for the $1,000 annual benefit and the $1,500 annual benefit, respectively.
This plan also allows vision and hearing benefits as well. As mentioned earlier, you would draw from the same annual benefit. Reimbursements are as follows:
How great is that? You have dental, vision, and hearing coverage all into one!
The disadvantage: this plan is not offered in every state.
Aetna DVH is also a solid “combo” plan. It also uses the careington dental network. However, plan differences exist between Manhattan Life and Aetna.
For one, Aetna has a $100 deductible that Manhattan does not. They are also a bit less expensive than Manhattan Life, but this premium difference is usually offset by the deductible.
One of the issues we see with Aetna is that they have a cap on vision care, up to $200 every two years. However, the plan pays in addition to any benefits paid by other stand-alone vision insurance you have.
Nevertheless, they are a solid option for a combo DVH. Moreover, they exist in more states than Manhattan does.
There are a few more carriers that offer a combo dental, vision, and hearing insurance. We, however, did not include them here because they either were much higher in premium for a lower value benefit or had low payment rates.
Key Takeaways For Seniors Wanting Dental Insurance
Now that you have an idea of the dental insurance plans we like for seniors, let’s talk about some important takeaways about coverage.
First, going to an in-network dentist is key to saving money on your dental insurance. If your dentist does not accept any insurance, then a true PPO plan helps. You want a true PPO plan with a high UCR payment to the dentist.
Second, waiting periods matter. Try to avoid insurance policies that have a waiting period.
Third, the cheapest policy isn’t always the best. The right plan for you is the one that strikes the right balance among premium, coverage, and value.
We hoped you learned more about dental insurance plans we like for seniors. You have many options. Need assistance or want to learn more? Feel free to contact us or use the form below. We would be happy to help you find an affordable insurance plan for you. And, if we don’t, you’ve learned a little more, and we will part as friends. Really! There’s no risk of speaking with us. Remember, we work in your best interests only, so we have no problem letting you know if a better dental insurance exists. This is the only way we know how to work with our clients. If there is a better plan available that we can’t offer you, we would be happy to help you obtain or recommend that plan to you.