Dental Insurance for Seniors Over 65: What You Need to Know

July 9, 2021

Once you turn 65, you’ll need to consider how you’ll pay for dental-related costs. Medicare will not cover dental care unless it’s related to a hospital stay. Medicare Advantage plans do, but the coverage varies and is usually minimal.

The Center for Retirement Research at Boston College reported in March of 2017 that the percentage of people with dental coverage declines by more than half within 10 years after retirement. Retirees are left with limited means with few options for dental care, so it’s essential to consider dental insurance before you retire so continue to receive care that is vital to your health.

dentist on ipad

Source: Getty

Understand Your Dental Insurance Terms

Dental insurance over the age of 65 is similar to the plan you may have had with your employer before you retired. The terms remain the same:

  • Annual or maximum benefit: Amount the insurance will pay each year

  • Basic services: Dental services such as cleanings, cavity repair, X-rays

  • Copay: Portion of the bill you are responsible for after dental insurance pays

  • Major services: Bridges, crowns, dentures, root canal

  • Deductible: Amount you pay before insurance covers dental costs

  • Indemnity or fee-for-service plan: You can use almost any dentist, and the plan pays a portion of the charges with no out-of-pocket maximum

  • In-Network and Out-of-Network: Using an in-network dentist will always cost less than an out-of-network dentist

  • Preferred Provider Organization or PPO plans: Insurance contracts with dental providers to create a network of participating providers

  • Premium: Amount you pay for insurance coverage

  • UCR: Usual, customary and reasonable, pertaining to what dentists in your location charge for a procedure, the basis for insurance company costs

  • Waiting period: Preventive services are covered on the first day; basic services at six months; major services at 12 months

What do Senior Dental Plans Cost?

If you are enrolled in Medicare Advantage, your plan might already include dental coverage. If you’re not, the cost of a stand-alone dental insurance plan depends on the amount of coverage you need or want. The majority of dental insurance plans come with a maximum annual benefit or coverage limit of $1,000 to $2,000. On average, people in the United States pay anywhere from $15 to $50 per month ($360 annually) for a stand-alone dental insurance plan.

dental insurance

Source: Getty

What Does Dental Insurance Cover for Retirees?

When doing your research, keep in mind the coverage allowed as well as the price of the plan. Dental insurance pays 100, 80, 60 or 50 percent of expenses, depending on the dental procedure. Here are a few examples of the coverage types:

  • Type I services: Preventive care, oral evaluations, bitewing X-rays, vertical bitewings, diagnostic casts
  • Type II services: Films, primary, permanent and resin-based composite, emergency pain treatment, fixed partial denture sectioning local anesthesia, nitrous oxide inhalation
  • Type III services: Inlays and onlays, re-cementing; crowns, sedatives, fillings, endodontics, oral surgery; prosthodontics; periodontics

Dental Insurance Plans for Seniors

All is not lost if you did not sign up to continue your employer’s dental care plan before you retired. Affordable dental plans for seniors are offered through many major insurance companies. Spirit Dental, mentioned in our guide, Best Dental Insurance for Seniors, offers benefits like a one-time deductible of $100, no age limit and preventative care with four plans to choose from. You can also consider a dental plan through an insurer through the Affordable Care Act.

Bottom Line

Dental plans for seniors are available from a variety of sources around the country. With some research, you can find the best one for your situation. Be sure you know five details before signing up for dental insurance:

  1. The cost of premiums
  2. Dental procedures covered
  3. The deductible amount
  4. The waiting period and pre-existing condition clauses
  5. Maximum benefit

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