Understanding Senior Dental Insurance Plans
Estimated read time: 10 minutes
Summary:There are several options available to help find quality dental insurance for seniors, such as opting for a Medicare Advantage plan with dental benefits, buying a standalone dental insurance policy or choosing a dental savings plan. Understanding the dental options available to you can make sure you have the coverage you need and that it aligns with your budget.
A healthy mouth is important to your overall well-being, and it starts with good oral hygiene like daily brushing and flossing. You’ll need these habits throughout your lifetime, but you also need regular dental exams and occasional treatments.
Regular dental exams and treatments may help you overcome some of the dental challenges that come with age, such as wearing dentures or repairing previous dental work.
While dental care can be expensive, dental insurance—especially plans designed for seniors—can significantly reduce what you pay out of pocket.
The importance of dental insurance for seniors
Good dental care is important at any age, but especially for seniors. Most people acquire cavities throughout their lives, which often require permanent fillings.
As we age, those cavities and fillings often need additional care. In some cases, this can even lead to the need for dentures. Similarly, untreated gum disease can lead to complications like periodontal disease.1
Getting regular dental exams is important because it can help seniors treat these issues. In addition, rates of oral cancer tend to rise as you age, and a regular dental exam can help you catch it early when treatment is more likely to be successful.
Seniors may often take more medications to help manage chronic health conditions. These medications can sometimes cause adverse oral side effects that a dentist can spot and help mitigate before they become a problem.1
Without insurance, paying for this dental care on your own can be very expensive, especially if you’re living on a fixed income. But if you’re able to build room in your budget for dental insurance, you might be able to offset some of the expense needed to cover extensive dental work in the future.
Understanding dental insurance basics
Dental insurance, like healthcare insurance, can be confusing to many people. But the basics aren’t complicated. Common terms you’ll see include:
- Premium: The premium is the amount you pay for the dental insurance itself, regardless of how often it is used.
- Deductible: The deductible is how much you have to pay out of pocket for dental care before your coverage actually begins. Some insurance plans have separate deductibles for different types of dental care, such as orthodontics.
- Co-payment or co-insurance: After you’ve paid your deductible, your dental insurance will generally kick in to help cover remaining costs. Based on the service, your insurance may cover all of the remaining costs or only a portion of the costs. When only a portion of the cost is covered by insurance, then you are responsible for paying the remainder. This is known as co-insurance. For example, if your dental plan pays 80% of covered charges, you’re responsible for paying the remaining 20% of the dentist bill.
- Waiting period: Many dental insurance plans require a waiting period before coverage begins, typically for major services like dentures, root canals or crowns. These waiting periods help keep premiums affordable and encourage long-term enrollment, since dental care needs can be unpredictable.
- Maximum benefit: Some types of dental insurance plans limit payment to a specific maximum dollar amount per year. If you exhaust your coverage, you’ll be responsible for paying 100% of your dental bill past this benefit cap.
- In-network vs. out-of-network: Insurance companies often maintain a formal network of dental providers that they work with. These “in-network” dentists not only accept your insurance, but also typically agree to charge lower rates, which can further reduce your costs. On the other hand, “out-of-network” dentists may not accept your insurance plan, leaving you to pay more of the cost on your own.
- Health Maintenance Organization (HMO) vs. Preferred Provider Organization (PPO): An HMO and PPO are types of provider networks. Under a dental HMO plan, your dental care will be covered only if you visit an in-network dentist. A dental PPO plan, which is more common, allows you to visit any dentist you want, although your costs might be higher if you visit an “out-of-network” dentist.
Types of dental plans available to seniors
Seniors have several options when it comes to obtaining dental coverage, and each works in a different manner and may have different cost structures.
Dental insurance for seniors on Medicare
Seniors typically have two options for Medicare coverage: Original Medicare and Medicare Advantage (also referred to as Part C).
About half of all seniors choose a Medicare Advantage plan, which is offered by private insurance companies. Most Medicare Advantage plans include dental benefits, which is a major reason why many seniors choose them.2
However, it’s important to compare your options carefully, as dental coverage can vary significantly from plan to plan. Some Medicare Advantage plans only cover preventive services like exams and cleanings, while others offer broader coverage such as fillings, dentures, or even implants, but with limits on frequency, cost, or provider networks.3
Original Medicare, on the other hand, only covers dental care when it’s medically necessary for certain medical procedures, such as jaw surgery. It’s not a reliable option for ongoing dental care, which is why many seniors choose to add a standalone dental insurance plan.
Standalone dental plans
You’re not limited to Medicare when it comes to dental coverage. Standalone dental insurance plans can offer more comprehensive and consistent benefits than what many Medicare Advantage plans include. Some plans are designed with seniors in mind—offering features like higher annual limits or coverage for common age-related procedures—but anyone can apply, regardless of age. Because they’re not tied to Medicare, these plans often offer more flexibility in choosing your coverage level, dentist network, and premium. They’re typically sold directly by insurance companies, through licensed agents, or via your state’s Affordable Care Act marketplace.4
Dental savings plans
A dental savings plan, also known as a “dental discount plan,” isn’t insurance, but can still help you save on out-of-pocket costs. You’ll pay a monthly or annual membership fee, and when you need dental care, you can receive discounted rates from a dentist participating in the savings plan.
There are no claims to file or deductibles to meet—you simply show your dental savings card and pay the discounted rate at the time of your visit.
What’s covered in senior dental insurance plans?
Just like regular health insurance plans, dental insurance plans may cover some types of procedures differently than others. The main coverage categories you might see in different dental insurance plans for seniors include:
- Preventive care: Most types of dental plans typically cover 100% of the cost of preventive services such as routine cleanings, exams and X-rays. You’ll usually need to pay a deductible and co-insurance or co-payment on all other dental care, and sometimes for preventive care, too.
- Restorative care: Fixing cavities and cracks with fillings or crowns.
- Oral surgery: Covers minor procedures like removing a tooth or treating oral infections.
- Endodontics: Covers procedures dealing with the interior and root of a tooth, like root canals.
- Orthodontics: Pays for tooth-alignment procedures and devices like braces. Orthodontics are becoming more common among older generations as people keep more of their original teeth as they age.5
- Periodontics: Covers procedures related to your gums, as well as dental implants.
- Prosthodontics: Covers dentures and bridges, which a quarter of seniors rely on.2
Other factors to consider when choosing a dental plan for seniors
Not every dental plan is the same, especially for seniors. In order to choose the right plan, you’ll need to balance factors like the cost of dental care, plan flexibility, covered services and more.
Dentist access and network
Dentists vary in the types of dental plans they accept. It’s a good idea to check that your current dentist, if you have one, accepts the dental plan and is in network. If not, see how much the dental plan might pay toward an out-of-network visit, or you may need to seek out a new dental provider entirely.
It’s also beneficial to consider the types of dental care you may need in the future, such as dentures. Check that there are specialists in your area who accept these insurance plans so that when the time comes, you’ll be able to make full use of your benefits.
Total cost picture
There are two main costs for seniors to think about when it comes to getting dental insurance.
First, there’s a cost to stay covered — i.e., the premium. Some companies offer discounts, such as if you bundle your standalone dental coverage with a Medicare supplement plan. In general, choosing a plan with a lower premium means paying higher costs out-of-pocket when you need dental care, and vice versa.
Second, out-of-pocket costs when receiving care – including deductibles, coinsurance and co-pays. Consider your past dental history as a guide for determining the type of care you may need in the future. It’s a good idea to budget for these expenses ahead of time. Consider setting aside funds in a regular savings account or a Health Savings Account (HSA), if eligible, to help cover dental costs.
Plan type and flexibility
Another major decision is whether to purchase a PPO plan, which offers more choice but charges higher premiums, or an HMO plan, which may be cheaper but provides more limited coverage.
Coverage timing
If you have dental work that you need to get done sooner rather than later, check the plan details closely to see if there are any waiting periods for coverage to begin on that type of care. Take note of any other waiting periods, too, so that you’re prepared to wait for coverage to begin, if needed.
In some cases, it might be worth paying a higher premium for a plan that has shorter waiting periods, or even no waiting periods at all, for dental care that you need right away.
Annual benefit maximum
Dental plans may contain annual maximum payout limits on covered care, after which you pay for the full cost. This can be particularly important if you know you’ll require extensive dental work.
In such cases, it may be good to consider a plan with higher annual benefit limits. Another option is to spread out your dental work over a period of a few years.
Layering coverage with multiple plans
In some cases, seniors can ensure better dental coverage by mixing different dental coverage plans together.
If you receive some covered dental services through a Medicare Advantage program but need additional care, for example, purchasing an additional stand-alone dental plan can help expand the types of dental services that you can receive coverage for.
When to consider a dental savings plan instead
If you need immediate dental care or want, it may be worth considering a dental savings plan instead. A dental savings plan provides a discount on services rather than insurance, so there are no waiting periods or reimbursement procedures that you’ll need to follow.
Final thoughts: Is Dental Insurance Worth It for Seniors?
Keeping on top of your dental health is a good money-saving strategy that pays back in more ways than one. A dental insurance plan can help you balance the tradeoff between paying a premium for covered services and getting the dental care you need.
Plus, it’ll help you keep your smile for the years ahead. Compare dental insurance and dental savings plans to make the right choice based on your needs.
FAQs about Dental Insurance Plans for Seniors
Q1. Why doesn’t Original Medicare cover dental?
Legislation prevents Original Medicare from covering most dental work for seniors, although some procedures are covered in a limited context if it’s directly related to certain medical treatments. If your doctor needs to remove an infected tooth to ensure the success of an organ transplant, for example, Original Medicare may cover the cost of this dental work.
Q2. Are there dental insurance plans designed specifically for seniors?
Yes. Most Medicare Advantage plans offer a dental care component, or you can also obtain dental coverage through a standalone dental insurance plan, many of which are designed with seniors in mind.
Q3. Can I buy dental insurance after I retire?
Yes. Retired seniors can purchase their dental coverage through a Medicare Advantage plan, which may come with a monthly premium. You can also purchase a separate dental insurance plan or dental savings plan, which is open for anyone to purchase, regardless of age.
Q4. How do dental discount plans work for seniors?
Dental discount plans for seniors are not insurance plans. You’ll pay an upfront fee that unlocks a network of dentists, who have agreed to provide discounted dental services. When you need dental care, you’ll pay the discounted rate directly to the dentist, no claims or benefits forms needed.
Q5. What should I look for in a senior dental insurance policy?
Consider coverage for dental care that seniors frequently need, including major restorative work such as dentures. It’s also a good idea to ask your own dentist, if you have one, because they can help you identify what kinds of dental care you may need in the future.
Sources
1Dental Quality Alliance. Web page: Measuring Oral Healthcare Quality for Older Adults. Retrieved May 9, 2025, from
2University of Michigan Institute for Healthcare Policy and Innovation. Web page: Dental Care & Coverage After 65: Experiences & Perspectives. Retrieved May 9, 2025, from
3The Commonwealth Fund. Web page: How Much Do Medicare Advantage Enrollees Value and Use Their Supplemental Benefits? Retrieved May 9, 2025, from
4HealthCare.gov. Web page: Dental coverage in the Marketplace. Retrieved May 9, 2025, from
https://www.healthcare.gov/coverage/dental-coverage/
5American Association of Retired Persons. Web page: Getting the Facts Straight on Braces for Adults. Retrieved May 9, 2025, from
https://www.aarp.org/health/healthy-living/adult-braces/
6National Council on Aging. Web page: What You’ll Pay in Out-of-Pocket Medicare Costs in 2025. Retrieved May 9, 2025, from
https://www.ncoa.org/article/what-you-will-pay-in-out-of-pocket-medicare-costs-in-2025/
7American Medical Association Journal of Ethics. Web page: Why Don’t Medicare and Medicaid Cover Dental Health Services? Retrieved May 9, 2025, from
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