AARP is a membership organization in the United States of America, working towards providing a quality life to those aged over 50. AARP Dental Insurance is one such benefit that this organization provides to help the elderly avail regular dental checkups without adding stress to their pockets. This HealthHearty article gives some useful information on the various dental insurance plans that are offered under AARP.
Did You Know?
Michelle Obama, the First Lady of the United States, recently became the member of AARP on her 50th birthday which was celebrated on January 17, 2014.
AARP was founded in the year 1958. Initially, AARP was an abbreviation for American Association of Retired Persons, however in the year 1999, the abbreviation itself became a name (pronounced letter-wise) because the criteria for membership was not confined to only those who were retired, their age should be 50 or above.
This membership organization provides a wide range of services including Medicare supplemental health insurance, the AARP® Dental Insurance Plan being one of them. It is important to understand that AARP and its affiliates are not the actual insurers but endorsers. This organization receives royalties from insurance companies in lieu of referring insurance plans. The dental insurance plan is administered by Delta Dental Insurance Company. While Delta Dental Insurance Company insures the plan in some states, in certain states it is insured by Dentegra Insurance Company and Dentegra Insurance Company of New England.
AARP DENTAL INSURANCE PLANS
Mostly, there are two PPO plans that you may choose from. However, the organization has recently introduced a third plan (HMO/DHMO) which is available only in certain states. PPO stands for Preferred Provider Organization whereas HMO stands for Health Maintenance Organization. The details of these plans are explained as under.
DELTA DENTAL PPOSM PLANS
There are two options available under this category: Plan A and Plan B. While the first plan offers extensive benefits to the members in exchange of a moderate premium, which covers most of the dental procedures, the second plan provides reduced benefits comparatively, at a relatively low premium amount. The following chart will give you a detailed description of what is covered under both these plans, and what difference lies between the two.
AARP DENTAL INSURANCE PLAN BENEFIT CHART
|Plan A||Plan B|
|DELTA PAYS*||MEMBER PAYS||DELTA PAYS*||MEMBER PAYS|
|Diagnostic and preventive (includes exams, x-rays and cleanings). NOTE: In Plan A, no deductible required for diagnostic or preventive services. In Plan B, Calendar Year Deductible applies.||100%||0%||80%||20%|
|Periodontal maintenance cleanings (gum cleanings)||80%||20%||50%||50%|
|Restorations (including tooth-colored fillings)||50%||50%||50%||50%|
|Endodontics (root canals)||50%||50%||50%||50%|
|ADDITIONAL BENEFITS AFTER ONE YEAR OF CONTINUOUS ENROLLMENT|
|Periodontics (gum disease treatment)||50%||50%||50%||50%|
|Crown and cast restorations||50%||50%||50%||50%|
|Dental implant services||50%||50%||50%||50%|
|Temporomandibular Joint Dysfunction (TMJ)||50%||50%||50%||50%|
|ADDITIONAL BENEFITS WITH ANNUAL RATE PAYMENT|
|Dental Accident ($1,000 lifetime maximum)||100%||0%||Not a benefit in Plan B|
|DEDUCTIBLES AND MAXIMUMS PER ENROLLEE|
|Calendar Year Deductible||$50||$100|
|Calendar Year Maximum Benefit||$1,500||$1,000|
|Temporomandibular Joint Dysfunction – Lifetime Maximum||$300||$300|
|Bold items indicate the differences between Plan A and B.|
Source: Delta Dental Insurance Company
*For information on disclaimers, limitations, and exclusions, click here.
DELTACARE® USA DHMO PLAN
This plan has been introduced recently for the AARP members but is not available in all states. The main advantage that this plan offers is the predictability of set costs to help the members manage their budget. Also, unlike the PPOs, wherein the members have to wait for 12 months after enrollment to avail some additional coverage benefits, here, there is no waiting period to avail all covered benefits. The benefits of this plan are listed as under.
- No Annual Maximums or Deductibles: There is no annual maximum limit in this plan. Which means that you needn’t worry about exceeding any fixed amount.
- No Waiting Period: Once you have enrolled for the plan, all the covered services are accessible immediately unlike the PPO options.
- Fixed Amount of Copayment: Because the amount you are expected to pay for covered procedures is fixed, the risk of bearing additional expenses doesn’t exist.
- Wide Network of Dentists to Choose From: Under this option, you have a huge range of dentists from which you can choose one of your choice who will be taking care of your dental health and also coordinate other specialty treatments that you may need.
- Extensive Coverage: More than 250 procedures are covered under this plan. Also, any pre-existing conditions including missing tooth are not excluded. This plan also covers up to 2 years of active orthodontic treatment.
DELTACARE® USA SAMPLE PROCEDURES
|Procedures||Amount Paid by You|
|Office visit (D0999)||$5|
|Exam and X-rays (D0150, D0120 and D0270, D0274)||No Cost|
|Cleaning (once every 6 months) (D1110, D1120)||$5|
|Periodontal maintenance (D4910)||$45|
|Denture repair or replace broken clasp (D5630)||$55|
|Tooth-colored filling (one surface) (D2391)||$65|
|Simple extraction (D7140)||$14|
|Root canal-bicuspid (D3320)||$215|
|Periodontal scaling and root planning (D4341)||$60|
|Complete dentures (D5110)||$365|
|Dental implant services||Not Covered|
|Temporomandibular Joint Dysfunction (TMJ)||Not Covered|
|Comprehensive oral evaluation (D0140)||No Cost|
|Nutritional counseling for control of dental disease (D1310)||No Cost|
|Temporary crown (fractured tooth) (D2970)||$20|
|Palliative (emergency) treatment of dental pain (D9110)||$20|
|Adult orthodontics (D8090)||$2100|
Source: Delta Dental Insurance Company
- The aforementioned data has been taken from the official website of AARP Dental Insurance Plan. For more information, click here.
- The DHMO plan is available in selected states only, including California, Texas, and Florida, as of now.
|Compare Plan Options|
|Plan Features||Delta Dental Options||DeltaCare® USA DHMO Option|
|Plan A||Plan B||DHMO|
|Deductibles||$50||$100||No annual deductible|
|Maximums||$1,500||$1,000||No annual dollar maximums|
|Covered services paid at applicable percentage (for example, fillings are covered at 80 percent of allowed amount and you pay the remaining 20 percent)||Covered procedures have predetermined copayments for services provided by network dentists (for example, you may pay $65 for a tooth-colored filling (D2391))|
|Waiting Period||Additional benefits are available after 1 year of continuous enrollment||No waiting period|
|Dentist Network||Freedom to choose any licensed dentist: selecting a PPO dentist will usually result in the lowest out-of-pocket costs.||You select a dentist from a list of network dental facilities and you must visit this dentist to receive benefits|
Source: Delta Dental Insurance Company
The dental discounts that seniors can avail under the aforementioned AARP plans are tremendously beneficial. In fact, these can be availed not only by the senior members of the organization, but for their spouse/partner, partner to a civil union, and dependent children who are unmarried. Even their grandchildren who are less than 26 years of age are eligible for enrollment under these plans.
The reviews of these plans have been quite positive so far. Perhaps that is the one reason that AARP Dental Insurance rates are considered to be the most feasible for the amount of facilities and coverage that are offered. The flexibility, easy payment options, and the freedom of customization is what makes this the most appealing option for the senior population.