Dental

Original Medicare does not cover any dental expenses.  Nor do Medicare Supplements.  There are some Medicare Advantage Plans (MAPDs) that include some form of dental coverage as an extra.  These are usually limited plans and you must utilize a dentist in their network.  Some MAPD’s allow you to pay extra and get better coverage.

When you get down to basics, there are two main types of dental insurance plans. 

  1. Network based plans: The insurance company contracts with dentists and negotiate a payment schedule with them.  It is usually less than they would charge a normal paying customer.  The insurance company, then shares some of the saving with their clients.  They are Preferred Provider Networks (PPO’s) and you realize a savings only if you go to a dentist in network.  Some dental insurance plans have multiple networks.  Generally, the more you pay for your premium, the more dentists will participate.
  2. Indemnity Plans: Some dentists refuse to belong to a network or have few contracts.  Sometimes, clients want to use a dentist that is not in a network.  True Indemnity plans do not utilize networks.  You can go to any dentist you want.  Most dentists will file a claim with your indemnity insurance plan, however, worse case scenario, you pay the dentist and get an itemized bill.  You then submit that bill as a claim and you get reimbursed a set amount of money.

Neither type of plan is a great bargain, though PPO plans are usually a slightly better deal if you use their network.  All dental plans have a premium (amount the consumer pays to have the insurance), a deductible (amount consumer must pay before the plan starts paying),  limited benefits (only cover 50-80 percent of the charges) and waiting periods ( the time you must pay for your coverage before the coverage becomes available for payment) .  They are not standardized in anyway so comparing one plan to another can be difficult.

Some dental plans include some vision benefits, some let your add vision insurance (for an additional premium) and some work like a “pot of money” that you can use for dental, vision and sometimes hearing expenses.  All the plans limit the maximum amount of money they will pay out in one year.  The higher the premium, the more money that is available. Some plans increase the benefits if you stay with the plan more than a year or two.  Benefits do not roll over from one year to another.  They all have fine( but important) print.

 

If you plan on purchasing dental insurance coverage, I recommend talking to the insurance person at your favorite dentist’s office.  Sometimes, they can steer you in the right direction.  If you do get a PPO network plan, make certain you dentist participates by going to the insurance company web site and click, find a provider.

Please feel free to check out the dental companies below that I recommend.  If you are brave you can even enroll without my direct help. However, I am always willing to help and answer questions.

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