Finding Dental Insurance for Seniors

The exorbitant cost of dental care has made it mandatory for people to have dental insurance. It is always better to get a dental plan before the problem arises to get competitively lower rates. In December 2011, 42% of the American senior citizens had faced tooth loss to an extent of replacing it with dentures and implants. Like this, there are several other dental problems that people have to face as they age.

About 97% of the insured population opt for dental health insurance plans that are employment-based. This is because employer-based dental insurance is a group insurance plan that has lower premium requirements as against individual dental insurance. Such plans are available for senior citizens also. As far as senior citizens are concerned, cost-effectiveness is one of the parameters that an insurance plan must fulfill. Here, we will discuss each of the plans in detail with its pro and cons.

Dental Plan Types Available in the Market Today

PPO Dental Insurance Plans
(Good Coverage, but High Prices)

Preferred Provider Organizations (PPOs) are attractive due to the flexibility they provide while choosing a dentist. These plans can be regarded as gold for those who can afford it.

Big companies provide these plans to their employees as a privilege. Although their annual payment is more expensive than other options, PPO plans are easily available to individuals as well as groups. They offer the maximum benefit to members who choose dentists from within their provided network. Nevertheless, members have the freedom to opt for any dentist of their choice at the cost of some benefits.

Alternately they reimburse the member or directly pay the dentist. Before getting attracted to its perks, be aware of all the costs that accompany it. Also, it requires you to pay the deductibles before the coverage actually starts.

HMO Dental Insurance Plans
(Affordable Care, Reduced Flexibility)

Health Maintenance Organization (HMO) plans are cheaper than PPO plans and indemnity plans. They are commonly known as Dental Health Maintenance Organizations (DHMO). Just like PPOs, DHMO also covers a group of dentists that provide service at predetermined prices. They are famous among the employers who buy them for their employees, but an individual can also approach a DHMO policy conveniently.

For senior citizens, the low cost attached with this plan is the appealing factor. This plan does not provide you with any comfort while choosing your dentist. In fact, if you are required to consult a specialist, the insurance carrier will pay only for that specialist referred by your dentist.

The unique feature about this option is the way DHMO pays their network of dentists. The dentists are paid on the basis of number of patients they treat and are also required to accomplish a target. This leads to unprofessional treatment and discommode to the patients. In spite of the shortcomings, these plans are preferred due to their cost-effectiveness.

Dental Indemnity Insurance
(Traditional Dental Coverage for Seniors)

This was the basic plan introduced for the purpose of dental insurance. In this type, the policy holder has the freedom of choosing any dentist of his choice without any prejudice. It has a reimbursement mode of payment. The policy holder files a claim which is reimbursed by the insurance carriers.

It covers 50-80% of the cost incurred in a dental treatment; rest is to be borne by the patient. For this reason, this is not a favorite among the senior citizens.

Steps to a Perfect Choice

Today there are many ways of researching in order to find the perfect plan that solves all your problems. There are companies like Spirit Dental, Dental Plans, Medicoverage, etc., which offer easily accessible websites to search and compare a variety of dental insurance options. Four fundamental steps that one must follow while buying a dental insurance for seniors are listed below:

  • Step 1 – Use the online tools provided to search for all the dental plans available and narrow it down according to your need. Look at the procedures offered, some of them are not covered under various plans or covered at low percentages.
  • Step 2 – If you already have a family dentist, visit him for advice or to learn about the plans that he is covered in. If not, then call up few referred dentists and ask them for the schemes that cover them and check for the success of their practice.
  • Step 3 – After going through the above-mentioned steps, narrow down your selected plans to two or maximum three that represent the best combination of your preferred services and your favorite local dentist.
  • Step 4 – To make your final selection contact a licensed agent. He can help you with all the issues that you haven’t noticed and fill up the remaining loopholes, after which your final dental insurance plan will be ready.

Problems Associated with Dental Insurance
Managed care plans are the cheapest, and as a consequence, most employers have shifted to these from the erstwhile popular traditional insurance plans. Managed care plans force the insured to choose from the given network of doctors and do not provide coverage for preexisting conditions.
Traditional insurance plans result in the insured receiving only the cheapest treatment according to the Least Expensive Alternative Treatment (LEAT) clause, although one has the option of choosing the doctor. Again, preexisting conditions are not covered by the plan.
The best dental insurance plan for people who are employed, is definitely the Direct Reimbursement Plan, which in addition to being the only plan that covers preexisting conditions, also provides the benefit of deductible premiums to employers. However, there is the danger of the amount not being reimbursed by the insurance company.
Since the aforementioned plans are usually employment-based, and have certain restricting clauses as far as treatment and payment is concerned, these are not suitable for seniors.
The Best Alternative

Dental Discount Plans
They have assumed a great deal of significance from the perspective of ensuring cost-effective treatment without the usual hassles that are associated with dental insurance. These plans are an alternative to insurance. The plan works by allowing members to save up to 60% on various procedures like cleanings, fillings, braces, checkups and more. Some of the advantages of dental discount plans include:

No Waiting Period: People have to pay an annual or a monthly fee in order to become members. The membership card generally arrives within 7 to 10 days of joining the plan. The procedure for becoming a member does not require extensive paperwork. Moreover, there is no waiting period clause unlike Traditional dental insurance and Managed Care plans. Direct Reimbursement plan is the only insurance plan that does not have any waiting period requirement, but costs more and is typically employment-based.

Cost-effective: The annual membership fee is generally around $100. The members have the option of visiting participating dentists nationwide and availing discounts by showing the membership card. Members receive a discounted fee schedule for almost all procedures and the least savings may be to the tune of 10%. The maximum savings, as mentioned earlier, is around 60% for certain procedures. Amongst dental insurance plans, managed care plans are the cheapest, but force people to choose from a narrow network of dentists. In addition to discounts on dental procedures, people may receive discounts related to vision, hearing and chiropractic care as well.

Less Encumbrances: These plans have less encumbrances as compared to other dental insurance plans, since they do not involve filing claims and other forms for predetermined benefits. In most cases, there are no plan deductibles or limitation on benefits. Unlike insurance – that does not cover cosmetic dental procedures – dental discount plans may provide discounts on procedures such as bonding or veneer.

It’s evident that dental discount plans provide a number of facilities that may be unavailable to people opting for dental insurance. Seniors, who cannot rely on employer-based insurance, can benefit to a great extent from these dental discount plans; so much so that dental discount plans have become synonymous with dental insurance for seniors.

The aim is to find a plan tailored just for you so that you can flaunt your big, toothy smile!