Dental Plans for Seniors

Dental Plans for Seniors

It comes as a surprise to some seniors that Medicare does not cover everything – especially surprising is that it doesn’t cover dental, glasses, or hearing aides.

To say “not all dental plans are alike” is quite the understatement.  There are HMO dental plans, such as DeltaCare USA, and there are PPO plans such as Ameritas (Spirit Dental), Blue Shield Dental, and others.  How do you know what to buy? Here is a quick summary of your options:

  • You must select a primary care dentist from within the plan’s network.  Be sure to pick a dentist that has openings for new patients.
  • Generally, the premiums are lower than for PPO plans.
  • Generally, all services will be covered without a waiting period.
  • Generally, all services will have a copay based on a Schedule of Fees. Preventive care is usually no cost, one visit per every 6 months.
  • Generally, there is no annual maximum of services.
  • You should select an in-network dentist to get the optimal benefit from your plan.  Networks can be found at the plan’s website, but always call the dentist first as online lists may not be 100% accurate.  Using a network dentist can save you 25-50% off averages for your area.
  • Usually there are waiting periods for certain services (often 12 month wait for Major Services, 3-6 month wait for Basic Services).  Preventive care visits are typically covered right away at no cost, one visit per 6 month period.
  • PPO plans have a deductible for Basic and Major Services; some PPO’s have a deductible for Preventive Services, even if you stay in network.
  • PPO plans have an annual maximum (the most they will cover in a year). The annual maximums on PPO plans range from $500 up to $3500.
  • Some dental PPO plans increase the coverage percentages by the number of years you have had the plan.

Spirit Dental uses the Ameritas PPO Classic network of dentists on all plans.  If you want to use an out-of-network dentist, try the Spirit Choice plans, which will reimburse using Usual and Customary charges per dental provider area. Click here to get a quote and apply:   



DeltaCare USA is an HMO Dental plan, which uses an HMO network of dentists.  Click here to get a quote and apply:



Blue Shield offers a variety of PPO and HMO dental plans, premiums vary per plan.  Contact us to get a quote and apply: