While the thought of sitting in a dentist’s chair is something that makes many people anxious, it is a necessity for people of all ages. Unfortunately, this anxiousness is not the only issue. Many people avoid the dentist because of the cost.
One way to reduce these costs is with the right dental insurance. Some employers provide this, while some people purchase it privately. In either case, it is essential to find a plan that covers your dental needs and the dental needs of your family.
If you need to purchase dental insurance, you may be confused. There are a lot of options, which may make it difficult to choose. Keep reading for some helpful tips on purchasing the right dental insurance for your needs.
Understanding the Basics of Dental Insurance
Dental insurance provides you with the coverage needed to pay for dental work. The policies can help you pay for all or a portion of the work your dentist does. This includes everything from X-rays and routine cleanings to dental implants, teeth whitening, and more.
While dental insurance is similar to health insurance, the premiums of it may be lower; however, there is a catch. Most insurance policies will cover most of the high costs of dental care once you have covered the deductible. Some have an annual out-of-pocket maximum, along with a deductible of $50 to $100. This is not how dental insurance works. With this coverage, it will usually follow the 100-80-50 coverage structure.
If you choose an in-network dentist, the dental plans will usually pay about 100% of preventative care, which includes cleanings, X-rays, and exams. However, necessary procedures, such as extractions, root canals, and fillings, will only have about 80% of the costs covered, and major procedures, like gum disease treatment, implants, bridges, and crowns, will only have 50% of the expenses covered.
Orthodontia treatments, along with cosmetic dentistry services, are not considered treatments that are medically necessaire, which means they probably will not be covered. If you undergo these procedures, you will have to pay out of pocket to cover the entire bill.
You can find several policies, from individual and family plans to group insurance. There are three main categories of coverage.
The Indemnity Dental Plans
Indemnity dental plans are typically the most expensive, and, as a result, they are not as commonly seen on the market. These are often referred to as a “fee-for-service” plan. With these, insurers will cap the total amount of money they will pay for different procedures. If you have a dentist that charges more than what is covered (or the cap), you will have to pay the difference.
If you find an insurance company that provides indemnity plans, you will likely have to pay for the entire cost and file a claim. After the claim has been approved, the insurance company will reimburse you. One of the most significant benefits offered by indemnity plans is that it does not have a set network, which means you can choose any dentist you like.
PPO – Preferred Provider Organization
The PPO is a common type of plan. Dentists will join the PPO network they choose and then negotiate the fee structure with the insurers. If you decide to use the services of an out-of-network provider, you have to pay more out of pocket.
These plans are often more expensive because of the administrative costs that are associated with the plans. However, they do offer more flexibility than others because they usually come with a much more extensive network.
HMO – Health Maintenance Organization
With the HMO, you will pay an annual or monthly premium. However, you are restricted to the network. What this means is that you may have to live in a nearby area where the HMO is being offered. It is usually the most affordable of the three types of plans, where dentists agree to charge fees for more specific services.
Is Group Coverage an Option?
Most people who have dental insurance receive benefits from their employer or another group coverage program, such as the Affordable Care Act marketplace, AARP, or a public program like Medicaid.
Usually, these plans are not as expensive as buying insurance on your own, and they typically come with better benefits. However, you need to look at the employer-sponsored plan and decide if the premiums are worth the investment.
Look into Individual Policies
An individual policy is more expensive than group policies. This is true regardless of if you are purchasing a policy for yourself or one that provides coverage for your entire family. However, there are some drawbacks to this coverage. The benefits are more limited, and if you are insured, you may have to wait before having a significant procedure approved.
If you have plans to sign up for a plan in time to have implants or dentures created, it may not work out. Insurers know about this tactic and will usually require a waiting period before you can start using the benefits. This waiting period may be a few months or a year – it all depends on the procedure. While some plans do not have a waiting period, they usually come at a higher cost.
Before deciding, you need to compare policies. Take time to get quotes and details about the policy from the insurance company website or by calling and speaking to a representative.
Finding the Right Dental Insurance Policy
When it is time for you to choose a quality dental insurance policy, there are a lot of factors to consider. If you want to get quality coverage that is going to help you get the benefits you and your family need, use the tips and information here. It will help you make an informed decision and find a policy that works for you now, and that will work for you in the future.
If you need help, contact the professionals. They can answer any questions you have about dental insurance policies.