Written by David Kurtz
President of Senior Benefit Services, Inc. – 33+ Years of Medicare & Life Insurance Expertise. Providing localized support through our physical offices in Hagerstown, Thurmont, and Cumberland, Maryland.
Over my 33 years as a licensed health and life insurance agent, one of the most common questions seniors ask at our Hagerstown, Thurmont, and Cumberland offices is, “How do I pay for my dental care now that I have Medicare?” As a senior, taking care of your teeth is crucial for both your oral and overall health. Here, we’ll discuss everything you need to know about dental insurance options, so you can make an informed decision.. Find out what Medicare covers on these services in our other article.
Original Medicare (Parts A and B) does not cover routine dental care, including cleanings, fillings, extractions, or dentures. Medicare will only cover dental services if they are strictly medically necessary for a covered inpatient procedure, such as a jaw fracture repair. For standard oral care, seniors must explore standalone dental insurance or Medicare Advantage (Part C) plans that include dental benefits.
When evaluating dental insurance alongside Medicare, seniors should prioritize four main factors:
In general, no. While there are some government-funded dental clinics, such as those run by the Department of Health and Human Services or the National Association of Free & Charitable Clinics, they have limited availability, eligibility requirements, and services. Some states also offer dental coverage under Medicaid, but again, the benefits and criteria vary by state. Your best bet for affordable dental care as a senior is to shop around, negotiate rates, and ask for discounts or payment plans from your providers. You can also consider joining a dental savings club, which typically offers discounts on a wide range of dental procedures with no waiting periods, annual limits, or paperwork.
The option that gives you the flexibility to get the benefits you need at the price you can afford is a stand-alone dental plan.
While there is no one-size-fits-all answer, some dental insurance plans that are popular among seniors and offer comprehensive coverage include APEX Dental, United National Life, Cigna, Mutual of Omaha, Manhattan Life, and Humana. These plans typically cover preventive care, basic and major services, with options to customize your deductible, coinsurance, and premiums. However, be aware that some plans may exclude certain procedures or providers, have waiting periods or limitations on coverage, or require preauthorization for specific treatments.
The APEX dental plan is a newer plan that came onto the market in recent years. It uses a PPO network of dentists and is currently available in 13 states with more being added almost each month.
What we like about it:
NEED MAJOR DENTAL WORK SOON? Click on the Speak With An Advisor on the right side of your screen. In the message section be sure to request all Options that Waive Waiting Periods.
The dental plan from UNL is one of the only plans on the market that does NOT use a network of dentists. This means you can literally go see any dentist that you want. While your chosen dentist may not file the claim, this plan still permits you to see them. Simply pay the dentist upfront, then provide your agent with the itemized billing to file the claim. UNL will send you the reimbursement payment directly.
What we like about it:
The Manhattan Life dental, vision, and hearing plan has been on the market for a number of years and continues to be a client favorite. While you can choose your dentist, you will get the most bang for your buck by using one that is in their network. The plan uses the Careington network which is quite robust.
What we like about it:
If you seek a budget-friendly, no-frills dental plan, this might suit your needs. The plan works best for folks whose dentist is in the network. This plan does not offer any hearing or vision benefits.
What we like about it:
Not sure which network you current dentist accepts? Click on the Speak With An Advisor on the right side of your screen. In the message section be sure to request a No-Cost Network Verification for your provider.
In summary, finding the right dental insurance for seniors on Medicare can be challenging, but not impossible. By understanding your dental needs, budget, and preferences, and comparing various plans and options, you can make an informed decision that suits you best. While we have outlined some great plans above, be sure to contact us at (800)924-4727 to see what other plans we have available in your state.
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