The “Journal of Prosthetic Dentistry” states that more than 37.9 million Americans will need access to dentures in 2020.
If dentures are on your horizon, it’s likely you also need to look into affordable dental insurance to help pay for them. Take a look at Benzinga’s guide to find the best dental insurance that covers dentures.
Best Dental Insurance Providers that Cover Dentures:
- Best Overall: Cigna
- Best for Dental Discount Plan: Careington
- Best for Full Service: Humana Dental Loyalty Plus PPO
- Best for Seniors: Spirit Dental
- Best for Choice: Delta Dental
Does Dental Insurance Cover Dentures?
The majority of dental insurance plans provide some coverage. Plans categorize dentures under restorative covers, so 50% coverage of denture services is standard.
You may come up against some limitations in your denture coverage under a standard policy, such as a waiting period of 6 months to 1 year as a new patient. Most standard dental policies also have a $1,000 annual limit, which won’t even come close to covering your denture bill.
It’s possible you won’t have any coverage for major restorative procedures like dentures if you have a low premium or high-deductible plan. Your best bet is to look for a provider early on if dentures are going to be necessary. Open enrollment is a great time to make the switch.
Types of Dental Coverage
You can find a wide range of dental coverage plans out there. It’s normal to feel confused by the array of options. If you’ve never shopped around outside what an employer provides, here’s a quick breakdown of the coverage types you’ll encounter in the market.
1. Preferred Provider Organization (PPO)
A PPO plan is insurance combined with a network of dentists that work with your insurance company. Your insurance provider and preferred dental providers agree to offer you specified services for set fees. You need to go to a preferred provider to ensure you have coverage.
2. Dental Health Maintenance Organization (DHMO)
DHMOs prepay contracted dentists a certain amount each month for each patient assigned to that dentist. Dentists must then provide certain contracted services at no cost or reduced cost to those patients.
The plan usually does not reimburse the dentist or patient for individual services. You must receive treatment at a contracted office in order to receive a benefit.
3. Indemnity Plans or Traditional Insurance
This type of plan is likely what comes to mind when you think about how insurance works. An indemnity dental plan — also known as traditional insurance — pays claims based on the procedures performed. The insurance company usually pays a set percentage of your charges.
Some plans let you choose your own dentist, but others require you to visit within a network like a PPO. Most plans have a maximum allowance for each procedure.
4. Direct Reimbursement
Reimbursement is a self-funded plan. You can go to the dentist of your choice. Some plans ask you to pay the dentist directly and request reimbursement. Other plans pay the dental office directly. Reimbursement plans don’t limit the services — your limitations hinge on total dollars spent.
5. Point of Service (POS) Plans
Point of service plans allow you some choice in providers — for a price. You’ll still designate a primary dental office. But you have the option to find treatment out of network. If you do that, your reimbursement will be based on a low table of allowances and your benefits will be less than if you had service within your network.
6. Discount or Referral Plans
Discount and referral plans aren’t insurance, but they can still help you manage the costs of dental care. The discount provider contracts with a group of dental offices and essentially sells you a card that gets you services at a discounted price. You pay the discounted rate when you receive care.
7. Exclusive Provider Organizations (EPO)
Just like the name suggests, exclusive provider organization plans require you use only participating dentists to be reimbursed by the plan. These plans strictly limit provider choices and access to care.
8. Table or Schedule of Allowances Plans
These plans pay a set dollar amount for each procedure, no matter the actual charges. You’re responsible for the difference between what your plan pays and what your dentist charges. Sometimes these plans are paired with a PPO so dentists are given a maximum amount patients can be charged.
Average Cost of Dental Insurance that Covers Dentures
An individual dental policy averages about $350 per year. You may pay $500 or more for a family. Dental discount plans are about half that cost or even less. You’ll usually pay your dental insurance premium monthly, while a discount plan is an annual payment.
Many dental plans have an annual cap for reimbursement — $1,000 to $1,500 is normal. Dental discount plans usually don’t have a cap.
Cheaper dentures run $400 to $1,000 per plate (the top or bottom of your jaw), and custom dentures are at least $2,500 per plate.
What to Look for in a Dental Insurance Provider
Anytime you shop for insurance, pay attention to factors like customer satisfaction and what you’ll end up paying for a premium each month. Strike a balance between both — don’t overpay for services you don’t need, but don’t choose the cheapest provider if it doesn’t support your individual needs.
The most important qualifications for dentures are whether the provider covers dentures and the annual cap for reimbursement. Because annual caps are usually much less than the cost for a set of dentures, dental discount or savings plans can be the best route for denture savings.
Best Dental Insurance Providers that Cover Dentures
Transitioning to dentures is a serious investment and a solid dental insurance or savings plan can help you afford the change. Take a look at our best dental insurance providers that cover dentures.
1. Best Overall: Cigna
A dental savings plan never has a wait period and you’re guaranteed acceptance. Cigna comes in at best overall for denture coverage because its benefits balance wait time and savings.
Cigna’s CIGNAPlus dental savings plan includes dentures. An individual plan is $131.71 per year. Cigna claims you could save more than 40% on your total cost for dentures immediately, and most traditional insurance plans cover 50% after at least a 1-year wait period.
Cigna works with more than 110,000 providers throughout the country, so finding a dentist that can partner with your plan for maximum savings is possible.
2. Best for Dental Discount Plan: Careington
Careington is another dental saving plan provider that can help you pay for denture work immediately. The Careington 500 Series dental savings plan lets you take your discount immediately, and individual plans come in at just $131.71 per year.
You can save nearly 40% on dentures with the plan, and your routine preventive or minor dental work qualifies for a discount too. There is no authorization and no annual limits. Also, don’t forget that savings plans require no claims paperwork. And what you pay at the office after your dental work is all you’ll pay.
3. Best for Full Service: Humana Dental Loyalty Plus PPO
Humana’s Dental Loyalty Plus PPO plan could be worth the wait. The first year of the plan Humana only covers 20% of your denture bill, but by year 3 it will cover 50%.
Humana’s monthly premium averages $34.99, and the annual maximum increases from $1,000 to $1,500 between year 1 and year 3. You can see any dentist, but if you stay in network, you can save more than 25%.
On top of denture coverage, this plan offers 100% coverage of preventive care, your choice of dentist and a one-time deductible.
4. Best for Seniors: Spirit Dental
Spirit Dental has coverage with seniors in mind — your acceptance is guaranteed and there is no age limit.
Spirit Dental includes dentures in the 3rd year of coverage and offers an annual maximum of $1,250. The monthly premium averages $27.60, and 50% of your total denture costs will be reimbursed. Spirit offers a $100 one-time deductible.
While you wait for denture coverage, 3 cleanings and 2 exams are 100% covered each year.
5. Best for Choice: Delta Dental
Delta Dental has 2 options for denture coverage — Preferred Prime and Platinum Prime. Both are PPO plans and both require a 12-month wait for dentures. After the wait, both covers 50% of your denture costs. The biggest differences are the monthly premiums and annual maximums.
Preferred Prime offers a $1,000 annual maximum and a monthly premium of about $40. Platinum Prime runs $57.22 each month, but the maximum is $2,000. Depending on your provider and the type of dentures you choose, Dental Dental could help you foot the bill.
Find Denture Coverage Today
Whether you’re willing to wait or need help paying for dentures soon, there is a plan to fit your needs. Dental insurance can provide more comprehensive care over time, but a dental discount plan offers immediate savings with no period and guaranteed acceptance.
Shop around to weigh the benefit of time and savings — enter your ZIP code to compare quotes for dental insurance today.
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