A Comprehensive Guide to Dental Coverage for All Ages

Taking care of your oral health is important at all stages of life, but costs can skyrocket quickly if you don't have dental coverage. Dental insurance can help cover the costs, whether it’s for kids getting their first cleaning or adults with more complex dental needs.

According to the National Association of Dental Plans, about 290 million Americans (87%) are covered by some form of dental benefit.¹ Understanding how dental coverage works and how plans differ can help you choose the best policy for yourself and your family.

Learn more about dental insurance for every age group so you can protect your smile and your wallet.

Introduction to dental coverage for all ages

Dental insurance helps defray the costs of dental visits and procedures, which is a key part of healthcare for all ages. Experts recommend that babies first see the dentist within six months of their first tooth erupting or 12 months at the latest.²

Here are some common dental services by age group. However, the type of care an individual needs will vary depending on their dental needs, no matter their age.

• Pediatric dental care: This tends to focus on preventive dental care, such as regular cleanings or fluoride treatments. Kids may also need to have their wisdom teeth removed or get fillings if they have a cavity.
• Dental care for adults: Adults would continue with regular cleanings, but may also have more complex needs, such as fillings, root canals, or crowns. Dentists will also monitor for signs of gum disease and tooth decay.
• Dental care for seniors: Seniors may have additional needs, such as dentures, dental implants, or periodontal care.

Medicaid can offer affordable dental care for low-income families, but it may not provide dental coverage for all ages. Children throughout the U.S. are covered under Medicaid benefits, but only some states cover adults through Medicaid.³

Traditional Medicare, which covers adults 65 and older, doesn't offer dental insurance for seniors.⁴ For this type of healthcare access, seniors can get dental insurance through a Medicare Advantage plan or a standalone dental insurance plan.⁵

Many working adults get dental coverage for families or themselves through their employer.⁶

Understanding different types of dental insurance plans

There are four main types of dental insurance plans: health maintenance organizations (HMOs), dental preferred provider organizations (PPOs), dental indemnity plans, and discount dental plans. Here's a quick dental insurance comparison of these plan types.

• Dental HMOs: These plans tend to have lower costs than a PPO, but may have a smaller network of dentists to choose from.
• Dental PPOs: PPOs typically cost more than HMOs, but have a larger network of dentists and dental specialists.
• Dental indemnity plans: With a dental indemnity plan, you pay your dentist directly and then submit a claim to your insurance provider for reimbursement.
• Discount dental plans: Also known as dental savings plans, discount dental plans are not insurance, but rather membership programs to access discounted dental services. To join, you pay a fee and then get reduced rates at participating dentists. These plans may be especially appealing to seniors who no longer get senior dental benefits through an employer.⁷

As mentioned, Medicaid dental coverage also extends to children across the U.S. and adults in some states. Medicaid may offer more affordable dental coverage options than private dental plans to families who meet the income requirements.

Comparing private and public dental coverage options

When reviewing dental coverage options, you'll find that dental insurance can come from private or public sources. Understanding how these types of dental care policies differ can help you choose the right plan for your needs.

Private dental plans

Private dental plans come from a private company rather than a government program. You might get one through your employer or purchase a policy on your own.

• Employer-sponsored private dental plan: Many employers offer private dental coverage to workers and may pay for a portion of the premiums. Employers usually offer plans through a specific insurer, but you might get to choose your coverage tier and plan type, such as an HMO and PPO. Some plans also offer dental coverage for families, which would be helpful if you've got children or other dependents.
• Marketplace and individual plans: You can also purchase private dental plans on your own directly from an insurance company or through HealthCare.gov, also called the Health Insurance Marketplace. The Marketplace lets you compare multiple plans at once, so you can compare premiums, covered services, and other features. Reviewing several options can help you find affordable healthcare access with benefits that meet your needs.

Public dental insurance options

Public dental care policies come from government programs, like Medicaid or the Children's Health Insurance Program (CHIP). Your household income will need to fall below a certain threshold to qualify for a public dental insurance policy.

By law, Medicaid is required to provide comprehensive dental coverage for children up through the age of 21.⁸ However, Medicaid dental coverage for adults varies by state, with some providing comprehensive healthcare access and others only covering emergency services.

CHIP provides low-cost health and dental coverage for children up to age 19 in families who earn too much to qualify for Medicaid.⁹

Exploring dental benefits for seniors

Seniors may have more complex dental care needs as they get older, such as dentures, periodontal care, or restorative work. However, nearly one in three (31%) don't have dental insurance to help cover costs, according to an NADP study.¹⁰

Retired seniors who no longer have insurance options through an employer have three main choices for senior dental insurance:

• Medicare Advantage: Also called Medicare Part C, Medicare Advantage is a type of health plan that can include senior dental benefits. You can enroll with a Medicare-approved private insurance company.
• Standalone private plan: You can enroll on your own with an insurance provider that offers dental coverage. Some providers offer plans designed for seniors that may provide more coverage for restorative procedures.
• Dental discount plan: As mentioned, this type of plan isn't a comprehensive dental plan but rather a membership program. It can connect you with reduced rates for treatments and preventive services for all ages at participating dentists.

If an employer-sponsored plan isn't an option, you can explore Medicare Advantage, contact private insurance carriers, or compare options on an online marketplace like HealthCare.gov or Dental for Everyone to find the best dental insurance for seniors.¹¹ Read the fine print to ensure the policy fits your and your family members' needs.

How MetLife supports dental coverage for all ages

MetLife offers flexible dental insurance plans that are designed to meet the needs of every age group, from children and families to seniors. MetLife's plans, which include both PPOs and HMOs, provide coverage for preventive care, restorative procedures, and orthodontics, depending on the plan.

Whether you get your MetLife dental insurance plan via your employer or you choose to get MetLife’s TakeAlong Dental^SM insurance yourself, you’ll get clear plan details and coverage information, and helpful customer support. You can also access your plan details in MyBenefits, MetLife's online patient portal.

The MyBenefits portal gives you a summary of your dental coverage, including your plan maximum, deductibles, and copays for preventive, basic, and major services. You can find in-network dentists, estimate your out-of-pocket costs, and view the status of any submitted claims.

In the portal, you’ll find an extensive network of providers, including those with the SpotLite on Oral Health designation. This designation is given to in-network providers that meet certain criteria for preventive oral health care.

Finding affordable dental coverage

If you're looking for affordable dental coverage options, shopping around is key. Here are some ideas for finding a cost-effective plan:

• Compare multiple options: Prices and coverage options can vary, so shop around to find a dental care plan that meets your needs.
• Check for an employer-sponsored plan: If your employer offers a plan, that may be your most affordable option, especially if the employer shares a portion of the costs.
• Explore public insurance options: If you qualify for Medicaid, which can provide medical and dental care for low-income families, find out if your state's plan offers dental coverage or if you can add it with a supplemental policy.
• Compare coverage tiers and deductibles: You may get to choose among different plan levels as you look for affordable dental care. You can reduce costs by opting for less coverage or a higher deductible, or get more comprehensive coverage with higher premiums.

As an alternative to traditional insurance, you could also explore dental discount plans, which can connect you with discounted rates at certain dentists. You might also find low-cost dental care at dental schools from dentists in training or community health centers that provide services for low-income families. Just make sure you're visiting a reputable facility.

Key factors to consider when choosing a dental plan

With so many dental insurance options to choose from, it can be tough to pick a plan. Here are some key factors to consider when doing a dental insurance comparison.

• Covered services: Review what services the plan covers and whether the benefits meet your needs. Most dental insurance plans cover preventive dental care, like cleaning and X-rays, to some degree, but coverage for other procedures can vary quite a bit.
• Family coverage options: If you have kids or other dependents, look for a plan that offers sufficient dental coverage for families.
• Costs: Check out the monthly premiums, along with the deductible you have to pay out of pocket before the plan pays out. Find out whether the plan has a cost-sharing structure too. For instance, some plans will cover 100% of preventive care, 80% of basic restorative procedures, and 50% of major restorative procedures.¹²
• Provider network: Find out about the plan's network of providers and make sure you have options in your area. Some dental plans only reimburse you if you use an in-network provider, while others offer some coverage for out-of-network dentists.

Preventive dental care: a cornerstone of oral health

The importance of preventive dental care is something to keep in mind when you consider your and your family’s health insurance needs. Taking care of your teeth will not only keep your smile bright, but it can also protect your overall health. Regular brushing, flossing, and dental cleanings can help you maintain your oral health and catch any problems early.

Dental insurance plans typically cover preventive services for all ages, such as cleanings, exams, and X-rays. Pediatric dentists help kids establish good oral hygiene habits early, while preventive care for adults and seniors can help protect them from gum disease and other issues.

A comprehensive dental plan usually includes the following preventive dental care services:

• Regular exams and cleanings, usually twice per year
• X-rays to detect bone issues and tooth decay
• Sealants to protect against cavities and strengthen enamel¹³

During your check-ups, dentists can also provide oral health education, from nutrition counseling to proper flossing technique. Following preventive dental care guidelines is important at every age to maintain your health and prevent major dental problems.

Make dental insurance a part of your overall health plan

Researching the right coverage for you, and for your family at all ages, is crucial for promoting oral health. Dental insurance can help pay some of the costs of preventive dental care and other services.

Pediatric dental care helps children establish oral hygiene habits early that will benefit them throughout their life. Adults and seniors benefit from healthcare access that keeps their mouth healthy and protects them from more serious (and costly) procedures later in life.

Pediatric dental care helps children establish oral hygiene habits early that will benefit them throughout their life. Adults and seniors benefit from healthcare access that keeps their mouth healthy and protects them from more serious (and costly) procedures later in life.