A dental plan for seniors is insurance coverage that enables senior citizens to maintain good dental health and oral hygiene. This in turn will help them fend off a slew of potentially serious health problems.
Most seniors are aware that Medicare and Medicaid do not offer dental coverage as one of their baseline services. As a result, with the exception of a limited number of Medicare Advantage plans, the elderly are pretty much left to fend for themselves when it comes to this critical quality of life issue.
Dental plans for seniors run the gamut from expensive and ultra-comprehensive, to moderately priced plans that cover an array of basic services, to discount plans that cover the bare bones minimum. In the list below we have brought together the 10 best dental plans for seniors in 2020.
1. Delta Dental
Delta Dental offers generally outstanding dental coverage for seniors. By and large their plans are reasonably priced and cover most basic services 100%. Once you get into the more involved dental services the lower cost plans start to falter a bit. But not much. They’re basically reliable, don’t play games and won’t break most people’s bank.
What we like: We like the fact that Delta Dental offers an array of both PPO and HMO plans. That their deductibles are not as punishing as plans from some other companies. And we like that you have a choice of using out of network dentists.
We also appreciate the company’s online portal that makes finding a network dentist a relative breeze. Provided the senior in question is moderately web-savvy of course.
Flaws: Maybe the most significant flaw is that covered services can be significantly different from state to state.
2. Solstice Dental Plans
Solstice provides seniors with a choice of their HMO or PPO dental plans. They provide 100% coverage on most basic services regardless of your plan. And, best of all, they allow you to choose out of network providers. But wait, they also offer an HMO plan that lets you pick your own dentist. That’s pretty unheard of and accounts for why they’re near the top of our list.
What we like: We appreciate that, like Delta Dental, Solstice offers both PPO and HMO dental plans. We like that they provide for twice-yearly preventive exams. And that spouses can be included at a reasonable cost.
Their online portal is not as robust as Delta’s but it nonetheless makes it relatively easy to find a participating dentist. Also, their HMO plans have the unique advantage of allowing you to use your choice of network dentists. A big plus.
Flaws: Solstice is not widely available. Although if you’re planning on retiring to Florida you’re in luck.
3. Humana Dental Insurance
There are nearly 12.5 million veterans in the US age 65 or older. Many of them are living on fixed incomes that can make obtaining dental insurance difficult. What we love about Humana Dental Insurance is that they offer a discount to those folks through their Preventive Plus for Veterans program. You will need to commit to the plan for a year to enjoy the benefits, but it’s worth it.
What we like: We like that you can accrue benefits each year with the Humana loyalty program. We like that they offer a dental/vision combo that can save money on both. And those veteran discounts are always good to see.
With way over 100,000 dentists in their nationwide network you’re going to find a qualified dentist reasonably close to you. They also offer some of the best customer service in the industry.
Flaws: Plans tend to vary from state to state and the enrollment fees are pretty odious.
4. Aetna Dental Insurance
Aetna provides a wide array of dental plans for seniors that enable them to keep their choppers in good condition. And while prices can vary significantly between plans a few are quite affordable and provide good to very good basic dental coverage. They also offer several innovative insurance products including Aetna Medicaid for low-income seniors and discount plans for as little as $10 a month.
What we like: Aetna’s Dental Maintenance Organization (DMO) has no yearly cap or deductibles. It will cost more but it may well be worth it. The company also offers what they call ‘The Aetna Vital Savings’ dental card that offers significant discounts on various dental services.
We also appreciate that they don’t have a lengthy list of health restrictions and that, with many of their plans, there is no copay.
Flaws: While their DMO is deductible-free some of their more affordable plans are not. Also, Massachusetts residents are out of luck.
5. Guardian Direct
Guardian dental plans for seniors are some of the best you’ll find. On top of that they’re also some of the most affordable. They are known for their relatively streamlined paper trail, the massive size of their provider network and their fast turnaround time on claims. Preventive care is typically 100% covered while Class 2 services like fillings may be covered up to 90%.
What we like: With a network of more than 100,000 dentists there’s one out there for you. Their online cost estimator is also a useful tool that lets you get a ballpark figure of what your preferred coverage will cost. And we have to mention that preventive care is 100% covered.
Flaws: Unfortunately, Guardian has a waiting period for almost all of their dental plans. How long varies by plan. Their dental coverage also isn’t available in all states.
6. Cigna Dental Plans
Cigna Dental Plans are, for the most part, reasonably priced. In addition, you won’t pay a deductible on preventive treatments and only modest deductibles on restorative work. As a bit of icing on the cake there are no copays on basic services either. And finding a dentist is easy using their online portal. There, you can also view cumulative scores assigned to dentists by the patients who have used them.
What we like: The fact that there is no annual cap is nice. As is the fact that you can sign up your spouse. We like that there are no deductibles on preventive work and that they work with a network of nearly 90,000 dentists.
Cigna Dental Plans are for the most part quite affordable. And while there are copays due on restorative work there aren’t any on basic services like X-rays and cleanings.
Flaws: If you wander from the network it’s going to cost you. There’s also a $20 sign up fee for new members.
7. Careington Dental
The Careington Dental Plan offers access to high quality dental work at greatly reduced prices. It costs $99 a year to buy into this program. Once you do you can enjoy big discounts on the full array of dental services from an enormous network of providers. There are no annual spending caps and no waiting period before you can take advantage of your discounts.
What we like: We like the flat $99 annual cost for most people. And the deep discounts it provides on most services. We also appreciate that there are no invasive health checkups to endure and no pre-authorizations are necessary.
Another great thing is that there are no waiting periods and you don’t need them to sign on to see a specialist.
Flaws: Just remember, the $99 doesn’t pay for your coverage. It buys you access to discounted services. You’ll still need to pay the dentist. But you’ll pay a lot less than most people.
8. AARP Dental Plans
AARP have their fingers in just about every type of societal pie these days and dental coverage for seniors is certainly one of them. They offer 3 members-only dental plans that are administered by Delta Dental. One of those plans is a prepaid plan with no waiting period. All of their plans offer high-quality services at reasonable prices with most basic services covered 100%.
What we like: The plans that AARP enables you to buy into are generally high-quality plans. Some will even cover crowns, bridges, dentures and more. They’re a good choice for those who need more than just the occasional cleaning.
Flaws: There’s a 1 year wait before you can take advantage of the more comprehensive services like dentures.
9. Spirit Dental & Vision
Spirit Dental & Vision plans have no age restrictions, assure guaranteed acceptance and provide full coverage on preventive care services like cleanings. While some of their plans can get fairly pricey they do offer coverage on many restorative services too, as well as things like dentures and implants. That said, if you just want to go with a bare bones plan they offer that too.
What we like: There’s no waiting for full coverage. The $100 one-time deductible is fairly reasonable. You’re allowed 3 fully paid cleanings per year. And they offer dental implant coverage. Although to a limited extent of course.
Flaws: While the deductible is low monthly costs can be pretty high.
10. Renaissance Dental
The last of our best dental plans for seniors comes from Renaissance Dental. They have an enormous network of providers numbering in the hundreds of thousands so you’re sure to find someone near you. There are deductibles in play but they are usually fairly modest. And they offer some senior specific services such as denture repair. There is a yearly cap involved however. So keep that in mind.
What we like: They have one of the biggest provider networks in the country. They don’t enforce a waiting period for preventive care. And there is no deductible attached to that preventive care. We also appreciate that they let you know ahead of time if your desired service comes with a copay attached.
Flaws: The $1,000 yearly benefits cap isn’t going to do you much good if you need some serious dental work.
Why do Seniors Need Dental Insurance?
There is this misconception that most seniors have piles of cash they’ve been accumulating their whole life that they can draw on in an emergency. Like if they need to have extensive dental work done. But the fact is that’s simply not true (1). A huge percentage of Americans over 65 get 90% of their income from Social Security. Which helps explain why the #1 reason seniors avoid getting needed dental work is the cost.
The importance of maintaining good dental health has become blazingly apparent in recent years. With doctors the world over recognizing the connection between healthy teeth and a healthy body (2). With this in mind a good dental plan can make all the difference in the overall health of an older individual. It makes it possible for them to get the regular checks that help prevent small problems from becoming big ones. It also enables them to deal with things like lost fillings in a timely fashion. The upshot is that, in many ways, dental insurance is in fact health insurance for seniors.
How We Ranked
Insurance policies are often extremely complex and insurance companies less than forthcoming with relevant details about this plan or that. As such many of the most important features (or non-features) of a dental plan are couched in legalese and buried deep inside the infamous fine print. That said, it’s still possible to get a decent overall picture of a particular plan if you stay focused on some key elements.
We wanted to know exactly (or as close to exactly as possible) what a particular plan covers and what it doesn’t. And of the ones that are covered which ones are completely covered and which ones are only covered in part. In the case of partial coverage we wanted to know what percentage of the cost of the procedure was covered.
The size of the deductible (3) is another important component of any dental plan for seniors. After all, if it’s too big then what’s the point in having the dental plan at all? Also, if the dental plan comes bundled with a medical plan are there separate deductibles for each? The plans that wound up making our list had what we determined to be the most reasonable deductibles.
Another thing we looked for was the annual cap. Most every dental plan has a maximum it will pay out over the course of a year. Exceed that limit and you pay 100% of any additional costs for the remainder of the year. So the size of the yearly benefits cap is important.
Finally, we looked at things like whether office visits were covered, whether you have the ability to choose your own dentist and whether or not the policy compels you to use the cheapest available option or whether it covers whatever option you choose.
Dental plans for seniors help fend off the risk of cardiovascular disease. Heart disease is the number 1 killer in the US (4). And that is the case regardless of race or ethnicity. Anything that can be done to lower the risk of heart disease is a good thing. The dental/heart connection is well known, and is believed related to how the immune system responds to gum disease (5). So while the connection between dental and heart health is indirect it is still very real. Having a good dental plan allows seniors to make regular visits that can identify and correct problems before they cause or aggravate heart conditions.
Dental plans for seniors may help prevent oral cancer. Tobacco use of any kind greatly increases a person’s risk of developing oral cancer (6). But it’s not the only potential risk factor. Studies have found that in some populations poor oral hygiene is the only identifiable cause of oral cancer (7). But whether it is the lone cause or one of several potential causes the fact is that poor oral health has been shown to contribute to oral cancer.
Dental plans for seniors help them save money. How? Well, if a person has avoided the dentist for financial reasons and then wound up with cardiovascular disease or oral cancer any savings they enjoyed by avoiding the dentist will be wiped out by the cost of dealing with the major health scare. But beyond the cost of life threatening conditions, the ADA says that most emergency dental visits could have been avoided if people visited the dentist more often (8). Which, of course, a good dental plan will allow a senior to do.
Dental plans for seniors can help prevent pneumonia. That might seem like a dubious claim but it’s not. Pneumonia is a leading cause of death among the elderly (9). Most people, however, don’t make a connection between this respiratory condition and oral health. But it’s there. And the culprit is periodontal disease (10). Periodontal disease can cause bacteria to invade the lower respiratory tract and cause an infection. Before long the person may develop pneumonia and fall into dire health.
Dental plans for seniors can help prevent cognitive dysfunction. Of course the mere existence of the plan won’t do anything. But taking advantage of a good dental plan and maintaining good oral health may actually help prevent the onset of dementia. A recent study in the UK found that certain byproducts of periodontal disease were present in the brains of people who had died with dementia (11). This suggests a direct link between chronic gum infection and cognitive dysfunction. The mechanism by which this occurs is not as complicated as it might seem either. Apparently, bacteria from the gum infection enters the brain via the bloodstream and triggers an immune response that has the effect of killing brain cells along with the invading bacteria.
Dental plans for seniors can help prevent type II diabetes. It’s long been known that diabetes can negatively affect dental health. But researchers are beginning to understand the reverse is also likely true. That periodontitis can have a negative effect on a person’s ability to control blood sugar levels (12). Therefore, it is not such a stretch to conclude that a good dental plan that covers regular visits could go a long way toward helping adults prevent type II diabetes. (Just to be clear, however, regular dentist visits are not a green light for gorging on sugary drinks and chocolate cake. You’ll still need to eat a reasonably healthy diet.)
Dental plans for seniors can help them enjoy fresher breath. Older folks who don’t get to the dentist enough often develop bad breath (13). In many cases they’re not even aware of the problem. It’s not a character flaw, it’s simply the result of things like food decomposing between teeth, acid reflux residue or the aforementioned periodontal disease. A good dental plan when used to its fullest can help create a healthier, cleaner mouth and rid the individual of the scourge of halitosis.
Dental plans for seniors help them keep their vivacious smiles. There are untold numbers of elderly worldwide who resist smiling because they are ashamed of the condition of their teeth. But not being able to smile can have a negative psychological effect on a person. Just as surely as smiling regularly has numerous positive effects on a person’s self-image, personal interactions and outlook on life (14). Keeping your teeth in good shape as you age is the key to a vivacious, infectious smile that will lift not only your spirits, but the spirits of everyone around you.
Q: What does a senior dental plan cover?
A: The exact coverage you get will depend entirely on the plan you choose. As a general rule, however, senior dental plans tend to focus on prevention as opposed to emergency procedures, implants and the like. In that sense they’re not all so different than most other people’s dental plans. Some will cover certain emergency situations, such as a broken tooth or extraction. But even if they do they won’t typically cover 100% of the cost of such procedures. You can also expect that most plans probably won’t cover 100% of the price of a filling. More like 75 or 80%. Likewise, you will probably have to pony up for at least half the cost of a crown or root canal. Dentures are also unlikely to be covered in most cases.
Q: Can you see any dentist you want?
A: Again, this depends entirely on the dental plan you choose. Some allow you to pick any dentist in their network. Others assign you a dentist and if you go to someone else you’ll need to cover the cost yourself. If you currently have a dentist and are happy with him or her and want to keep them you should ask them which insurance plans they will accept and then see if it’s in your budget. Preferred Provider Organizations – commonly called PPOs – are a type of managed care plan that will provide you with a list of dentists to choose from.
At the other end of the dental plan spectrum is the HMO. An HMO (Health Maintenance Organization) is almost always more restrictive in that they assign a dentist to you. In addition, it is likely they will have a smaller menu of dental services that they will cover. The upside of the HMO is that they tend to be considerably cheaper. As such, many seniors on a tight budget will opt for HMO coverage.
Q: What are the different classifications of dental work?
A: Every insurance company breaks their coverage options down into different classifications. Doing so makes it easier for customers to wrap their head around what is covered and what is not. And it also makes it easier for the insurance company to keep track of things. When it comes to dental coverage there are typically 4 classifications of coverage titled (not surprisingly) Class 1, 2, 3 or 4.
Class 1 coverage tends to deal with preventive care. X-rays, cleanings, cursory exams and the like all qualify as Class 1 services. These are often covered 100% by various dental plans, since good dental upkeep prevents big dental problems. Root canals, fillings and periodontal work typically fall into Class 2 coverage. This is defined as basic restorative work and a decent dental plan might cover up to 80% of such work.
Class 3 coverage is anything that entails major restoration work. Seniors often need this because they have allowed things to slip for years. Class 3 work usually involves things like crowns, bridges and dentures. Unfortunately, many dental plans for seniors won’t cover any of this type of work. Although there are a few that might cover up to 50%.
Lastly, Class 4 entails things like extractions, implants and the like. You might find a dental plan for seniors that will cover some of the cost for this type of work. But even so coverage will likely be limited to 50% or less. It’s also likely that there will be a fairly low annual cap involved of like $1,000 or so. But make no mistake, most will not cover Class 4 work at all.
Q: Is dental insurance for seniors worth the money?
A: The answer to this question depends almost entirely on the state of the person’s teeth. If those teeth are in basically good shape then getting dental insurance may well be worth it. That’s because it will cover basic services that will allow the person to keep their teeth in good condition and avoid expensive Class 3 or 4 work. On the other hand, if a person’s teeth are in rough shape they may actually find it cheaper to just fund repairs out of their own pocket. That’s because of the hefty deductibles that typically accompany restorative work.
In some cases, as we’ve seen, the dental plan may not cover restorative work at all. Which would make it useless as far as mitigating the financial hit the person would take from having the work done. So before deciding whether to get a senior dental plan do a no-nonsense assessment of the state of your teeth.
Q: Does Medicare Advantage provide dental coverage?
A: Medicare Advantage plans are created by private insurance companies that have been vetted and approved by Medicare. They must adhere closely to the rules Medicare lays out pertaining to health related services for the elderly. They are also allowed to offer a limited number of additional services that traditional Medicare does not. Including, in some cases, dental plans.
With a Medicare Advantage dental plan you would pay a monthly premium, just as you would with a regular insurance plan. And of course, there would be deductibles involved and limited coverage for certain types of service. It’s advisable to shop around and compare what you might pay for such a plan against what a more straight-up insurance company would charge. Medicare Advantage Plans are not always the best value.
Q: Are there any viable options to dental insurance for seniors?
A: For too many seniors dental insurance is beyond their financial capabilities. But that doesn’t mean they need to accept the gradual decay and loss of their teeth and all the problems that brings with it. While the available options are not likely to provide the same type of benefits as a good dental plan they can be useful in helping to prevent major problems. And, to a limited degree, dealing with larger problems.
Those options include Medicaid which, in some states, will cover a limited number of dental procedures and services. You should check with your local Medicaid office to find out if they offer anything in the way of dental services. There are also numerous clinics around that offer a limited number of reduced cost or free dental services for seniors (15). Although, to be sure, you may have to travel some distance to get to one.
Finally, there are things called Federally Qualified Health Centers, or FQHCs (16), that traditionally serve areas of the country that are otherwise underserved by mainstream hospitals and health centers. Some of these offer a limited number of different dental services on a sliding scale, based on the customer’s ability to pay. There are currently some 14,000 FQHCs or related centers nationwide.
Q: What is a dental discount plan?
A: Sometimes referred to as a ‘dental savings plan’ a dental discount plan is another alternative to standard dental insurance. With this type of coverage the person pays an annual membership fee and is granted access to a network of dentists at what are often significant savings.
Keep in mind though that the membership fee you pay does not cover the cost of the services. What it does is enable you to take advantage of those services at the aforementioned discount rate. Sometimes the discount can be as much as 50-60%. You’ll still need to pay out of your pocket each time you see the dentist. But it won’t cost you nearly as much as it would if you went on your own without any kind of insurance.
Q: Do dental plans for seniors cover dentures?
A: Some do and some don’t. As we mentioned earlier dentures are considered a Class 3 type of dental service. As such, there are some dental plans that may provide up to 50% coverage for dentures. Then again, that coverage may be as low as 10 or 20%. Or there may be a max limit in play that will cover something like $1,000 annually. So if you haven’t used the policy for anything prior to getting dentures it might cover the first $1,000 of the cost. However, some dental plans won’t cover them at all. So always read the fine print.
Dental plans for seniors are an important component of any comprehensive healthcare coverage. Having a good dental plan can help an elderly individual fend off an array of potentially serious health conditions including type II diabetes, heart disease, oral cancer, pneumonia and even dementia. So any debate about the cost of such a plan needs to be weighed against these important benefits.
The dental plans for seniors on our list provide varying degrees of coverage to be sure, and at various costs. But all are provided by reputable companies with a proven track record of dependability. If you are looking for a dental plan for yourself, your spouse or an elderly relative you are sure to find one on our list that will fit the bill.
For cpoe.org’s #1 recommended dental plan for seniors, click here.