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April 27, 2021Retirement Health
As a senior, quality dental care is important. However it is also expensive since it is not typically covered by Medicare. So what are the best options?
It is good to be aware of the different resources and programs that are available for low income seniors. In addition, it is important to look at different dental insurance providers to determine which ones suit your needs and your budget.
Check out the PACE program because it provides dental and other services to low income seniors. Also, see if there is a health center or dental school near you that provides low cost or free services. Finally, there are affordable insurance programs from major providers like Humana or Cigna.
The information in this article comes from Authority Dental, Just Care USA, Dentistry from the Heart, and several major insurance providers. The information is compiled to help you locate and digest the necessary information. In addition, here is a spreadsheet that includes information about the major insurance providers that provide affordable dental services to seniors.
Table of contents
The Program of All-Inclusive Care for the Elderly, or PACE, is a program that is based in many communities around the country. This program aims to provide care to older people in order to prevent or significantly delay nursing home placement. PACE partners with local sponsoring organizations as well as the Medicare and Medicaid federal health insurance programs.
In order to qualify for PACE, an individual must be nursing home eligible. Most participants have Medicare or Medicaid, but it is possible to privately pay for PACE services as well. The program is for people who are at least 55 years old and certified by their state to require nursing home care. In addition, they must be able to safely reside in their community and live in an area served by PACE.
PACE will provide services at home, around the community, and at the PACE center. The program often covers dental and other services that are not covered by traditional Medicare and Medicaid. These services may include things like adult day health care with physical therapy, nursing, meals, and other services. In addition, it can provide necessary OTC and prescription medications, dentistry, audiology, podiatry, optometry, and more. Check out this webpage to search for PACE services in your area.
Federally Qualified Health Centers (FQHCs) are directed by the Human Resources and Services Administration and are located around the country. These centers provide a plethora of services, including dental, to underserved populations. They may even waive the Medicare deductible and coinsurance if you have fixed low income.
Health centers regularly have access to pharmacy, mental health, and oral health services in areas that have limited access to affordable healthcare services. They provide comprehensive primary care and supportive services including transportation and health education. They will provide these services on a sliding fee scale depending on your income and ability to pay.
Most Health Centers around the country receive a federal grant from the Health Center Program in order to fund the quality healthcare services that they provide. Sometimes, these health centers get this funding in order to provide the necessary services to a specific population such as the homeless, the elderly, or those who live in public housing.
Check out this webpage to see if there is a health center near you!
A lot of dental schools have programs where the students manage a clinic. These clinics often provide low-cost, or possibly even free, services to the community. Their services are often significantly lower than the other dentists in their area.
The Dental Lifeline Network runs a program called the Donated Dental Services program, or DDS. This program offers completely free, comprehensive dental services to those who are elderly, medically fragile, and those with disabilities. The program works with a huge volunteer network that includes over 3,400 dental labs and over 15,000 dentists nationwide.
Check out their website for more information about the DDS program in your state!
Dentistry from the Heart is a worldwide nonprofit that aims to provide dental services to those in need. Each year, thousands of volunteers, dentists, practices, and hygienists around the country and the world donate their services and their time in order to participate. They each host their own events that offer basic dental services for free.
Their website has more information about the upcoming events.
There are fantastic dental insurance providers that are affordable, but still offer quality coverage. Check out these ones to see what might work for you. Check out this spreadsheet to get a quick rundown of the plans offered by these providers.
Delta Dental is a not-for-profit organization of nearly 40 different companies. They are the leading provider of dental insurance and serve millions of Americans. They have a contract with AARP that provides the members of the organization with affordable prices for seniors. They have both HMO and PPO plans.
Their HMO plan is called DeltaCare USA and they have Plan A and Plan B PPO plans. The HMO plan is the most affordable and it uses a network of accepted dental facilities. The PPO plans allow you to choose any dentist. There is no maximum and no deductible on the HMO DeltaCare USA plan and the PPO plans have an annual maximum of $1000 to $1500. The deductibles range from $40 to $90 depending on the plan.
This plan is designed specifically for seniors and they also provide resources for retirees. They have immediate coverage for fillings, denture repair, tooth removal, and root canals with the AARP plan. AARP members are guaranteed acceptance.
Humana has dental insurance plans in every state and provides a plethora of options depending on your needs. They have a Preventive Value PPO plan that has a lifetime deductible of $50 per person or a maximum of $150 for a whole family. This plan does not have waiting periods for basic services or preventive care.
They have a Dental Loyalty Plus PPO that has $150 per person lifetime deductible or $450 for a family maximum. This plan has no waiting periods ever. It has a yearly maximum that begins at $1000, but increases each year by $250. Then, their Complete Dental PPO has waivable deductibles for in-network preventive care and there is no waiting period for preventive services, but a 6 month waiting list for basic services and a 12 month waiting period for major services.
Also, Humana offers customizable plans and you can add coverage for vision or expand coverage depending on your needs and your budget.
Cigna is over 225 years old and is recognized for quality service at an affordable price. They do not have a deductible or copay for preventive care like cleanings and routine x ray examinations. They have a huge network including nearly 100 thousand dentists.
With Cigna, you have the option between three different dental plans that range in price and coverage. Cigna Dental Preventive is the most affordable and costs $19 a month. Cigna Dental 1000 costs $30 a month and provides coverage for additional dental work other than basic preventive care. The maximum coverage is $1000. Then, Cigna Dental 1500 gives you all preventive and restorative care as well as some orthodontia coverage and $1500 maximum for $35 per month. Deductibles are $50 per person or $150 for a family.
Cigna has a 6 month waiting period for basic coverage and a 12 month waiting period for major dental work. However, they may waive your waiting period if you have been with another provider before switching to Cigna. Cigna is a fantastic option for preventive care because they are affordable and have plans without deductibles or copay.
Aetna has a huge network of members and practitioners which can make it easy to find a dentist without having to go too far away from your home. They have plans available in most states and also have online account management. This allows customers to get cost estimates and find in-network dentists near them at the click of a button. You can also use their online account management to check claims, status, and statements.
Aetna provides two tiers of coverage for seniors called the Core PPO plan and the Preferred PPO plan. They have a $50 deductible per person or $150 deductible for family annually. Preventive services never have a waiting period under any Aetna plan. Basic services have a 6 month waiting period and there is a 12 month waiting period for major services. However, these waiting periods may be waived if you provide proof of prior dental insurance before switching over to Aetna.
They have annual maximum benefits of $1000, but this number goes up to $1250 if the services provided are in the network. Also, Aetna provides 20 to 50 percent coinsurance for basic or major care.
Renaissance offers dental, vision, life, and disability insurance and they have a plethora of different plans that have different premiums. Renaissance dental has no waiting period on cleanings. With their MAX Choice Plan or MAX Choice Plus plan, there is no waiting period for fillings or crowns. They have a yearly maximum from $750 all the way to $3000 and there is a $50 deductible for individuals and $150 for families.
Some of the plans under Renaissance Dental do not include major dental work like root canals or crowns. They do have plans available that provide 20 percent coverage in the first year. Then, they offer loyalty rewards that have increasingly more coverage for major work until the third year when they offer the maximum amount of coverage of 50 percent.
Aflac is a long-time trusted name in health and dental coverage. They insure over 50 million people and have splendid reviews and a low amount of complaints. Aflac will pay claim reimbursements directly and they also have online policy management so that you can access claims and status as well as additional coverage that can be added on.
They have no waiting period for wellness visits or for routine x rays. They have a 3 month waiting period for pain relief and a 6 month waiting period for extractions. Root canals have a 12 month waiting period and dentures have a 24 month waiting period. The annual maximums differ depending on the plan that you choose, but may go as high as $1600.
Aflac does not require in-network coverage and offers affordable, yet flexible, coverage for senior citizens.
United Healthcare has been around since 1974 and offers dental insurance in 44 of the 50 states. They also have four Dental Gen Plans that are specifically designed with seniors in mind.
United Healthcare’s Dental Gen policies come with options that are made for seniors and provide the option of adding additional services like hearing aid benefits or vision to the dental package. They also offer immediate coverage for a lot of their services. The basic Gen Saver Dental plan is the most affordable, but they have 3 tiers increasing from Gen Basic Dental and Gen Plus Dental. Their top-tier option is called Gen Deluxe Dental.
Preventive care on any of the Gen plans does not have any waiting period. Basic services have a waiting period up to 4 months depending on the plan, but some plans do not have a waiting period. Major services, when covered by a Gen plan, have a 6 month waiting period.
Gen Basic, Gen Saver, and Gen Plus all have $100 deductibles. Gen Deluxe has a $50 deductible. Their plans have maximums that range from $1000 to $2000. Preventive care is 100 percent covered on basic and Deluxe plans. On the other two plans, preventive care is 60 percent covered. Major services are covered 10 percent on day one and increase up to 50 percent after two years.
Guardian Direct is a branch of the Guardian Life Insurance Company. They offer three PPO dental insurance options. They have Advantage Bronze, Advantage Silver, and Advantage Gold.
Their Bronze plan is the most affordable and does not cover major work. Gold has significantly more coverage. All of their plans allow you to choose your dentist, but you can save up to 35 percent by selecting one that is in their network. Fillings have a 6 month waiting period and major work has a 12 month waiting period.
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