With no network restrictions and low monthly premiums, Spirit Dental offers our favorite coverage for seniors.
September 4, 2024 
Author: Amie Clark | 
Expert: Cory Smith | September 4, 2024 |
It goes without saying that as we age, our bodies require more attention. This is especially true of our teeth. However, Medicare doesn’t cover most dental care, including cleanings, tooth extractions, fillings, dentures, or other dental devices. While some people receive dental coverage through retirement plans, Medicare Advantage plans with dental, or employer-based plans, private insurance offers a surprisingly affordable way to pay for dental care, both routine and specialized. In this article, We’ll take a look at some of the broad strokes of dental coverage for older adults and highlight our favorite providers for seniors.
Older adults might want dental insurance because Original Medicare does not cover routine dental procedures, such as cleanings, fillings, dentures, extractions, and root canals. As dental health is crucial for overall well-being, neglecting it can lead to serious health issues like infections, heart disease, and diabetes complications. Dental insurance helps manage the cost of regular dental care, preventing expensive treatments down the line. It also ensures access to preventive care and timely treatments, maintaining oral health and quality of life. Thus, having dental insurance provides financial protection and promotes better health outcomes for older adults.
Navigating the dental insurance market can be a bit nerve-wracking, not unlike going to the dentist. To help you find the best dental plans for older adults, we evaluated them based on the following criteria:
Savings tip: If saving money is of the utmost concern, then take a look at my rundown of affordable dental insurance for seniors.
*Premium estimates are for a 65-year-old man living in Pennsylvania.
**If you haven’t had dental insurance in the past 90 days, you’ll have a waiting period of one month for resin fillings and uncomplicated extractions, six months for periodontal maintenance cleanings and occlusal adjustments, and 12 months for major services.
Spirit Dental offers a large number of dental plans for people of all ages. While each plan will differ slightly in terms of coverage and costs, they all provide full coverage for cleanings and exams. All of their plans also require no waiting periods for coverage to begin, even on major procedures.
| Spirit Dental plan | Spirit Preventive Plus PPO | Spirit Core PPO | Spirit Flex | Spirit Senior Preferred PPO | Spirit Pinnacle PPO | Spirit Flex Plus |
|---|---|---|---|---|---|---|
| Monthly premium | $18.30 | $31.40 | $35.78 | $39.30 | $42.25 | $49.79 |
| Deductible | $100 lifetime | $100 lifetime | $100 lifetime | $100 lifetime | $100 lifetime | $100 lifetime |
| Annual coverage limit | $1,000 | $1,200 | $2,000 | $3,000 | $5,000 | $2,500 |
| Preventive coinsurance | 100% | 100% | 100% | 100% | 100% | 100% |
| Basic procedures coinsurance | 50% | 50% | 50% | 65% | 50% | 50% |
| Major procedures coinsurance | 20% | 25% | 15% | 20% | 25% | 20% |
Finding a Dentist: Spirit’s dental plans are underwritten by the Ameritas Life Insurance Corporation, and they utilize the same dental network. To find an in-network dental care provider, all I had to do was go to their website and search by ZIP code.
When I looked in Portland, Oregon, the result yielded 368 providers in the PPO network, 200 of which were the closest match. To make things even easier, Ameritas (Spirit’s underwriter) highlighted the most cost-effective providers in green. I could sort by distance, showing the closest dentists first, as well as name and specialty. This easy-to-use website made finding a dentist a breeze. I could even create a PDF of the results and print it, convenient for those who prefer reading on paper as opposed to a screen.
Making a Claim: With Spirit Dental, your in-network dentist can file claims for you, or you can file them through their online claims manager. Personally, I like for my dentist to do it for me, so I can be in and out without having to do any paperwork or wait on long hold times.
Out-of-Network Coverage: Most of Spirit Dental’s plans provide full coverage within their network of dental providers; however, all of their plans allow you to use any provider, regardless of network. That being said, you’ll see more savings with an in-network provider. For example, with the Spirit Preventive Plus PPO plan, the Spirit Core PPO plan, the Spirit Senior Preferred PPO plan, and the Spirit Pinnacle plan, I could save 25 to 50 percent by going in-network.
Let’s say I have the Spirit Preventive Plus PPO plan, which, during the first year, pays for 50 percent of basic procedures. Let’s also imagine that I need a composite filling on two teeth, which costs $250, and that I have already paid my $100 lifetime deductible. In this case, Spirit covers basic procedures up to $750, but with the in-network discount (let’s say 25 percent), that could only cost $187.50. This leaves me with $562.50 for the rest of the year to spend on basic services, whereas if I had gone out-of-network, I would have only had $500 of coverage left, which could easily be wiped out by a major procedure and have me paying out-of-pocket.
Restrictions: Some of Spirit Dental’s plans increase in their coverage amount as you hold the policy for a number of years. For example, with the Senior Flex Plus plan, during the first year, the plan will cover only 50 percent of basic services and 20 percent of major services. However, in the second year, the coverage increases to 70 percent and 40 percent, respectively, then 80 percent and 50 percent in the third year.
Waiting Periods: All of Spirit Dental’s plans have no waiting periods. This is not the case with other providers like Delta and Humana, where you could wait up to a year for treatment with some plans.
