Around 250 million Americans receive dental benefits. While most people don’t enjoy going to the dentist, we all recognize how important dental care can be. Having a comprehensive dental insurance plan can mean the difference between living with a mouth full of cavities and having clean and healthy teeth.
However, you might be limited in what kind of work you can get done, due to the way certain policies are written.
With so many different options out there when it comes to dental insurance plans, it’s easy to get overwhelmed. Luckily for you, we’re here to help. So if you’d like to learn more then keep on reading and we’ll walk you through our ultimate guide to dental insurance plans.
1. Understand What Dental Insurance Is
With dental insurance, you’ll have coverage to help you cover the costs of certain dental work. These policies can help you pay for all or part of the dental work, from regular cleanings to implants to x-rays.
While dental insurance works in a similar fashion to health insurance, the premiums are usually a lot lower. Still, many health insurance plans cover a big percentage of expenses after you’ve paid your deductible. And they’ll also have an annual out-of-pocket maximum.
This isn’t the case when it comes to dental insurance.
If you’re using a dentist that’s in your network, the plan will usually pay for all of the preventative care. However, it will only cover eighty percent of basic procedures and fifty percent of major procedures. Cosmetic dentistry won’t be covered at all.
Some dental offices will give discounts to people who no insurance dentist.
2. Know the Kinds of Plans
Dental policies can range from individual and family plans to group insurance. They come in three main categories.
Indemnity Dental Plans
Indemnity dental plans aren’t that common and they are also the most expensive. These are also known as “fee-for-service plans.”
Providers cap how much money they will pay for certain procedures. If your dentist charges you an amount that’s higher, then you’ll need to pay that amount out of pocket.
Many insurance companies that offer this kind of plan will make you pay for the entire cost and then file a claim. After that claim is approved, the insurance provider will reimburse you for its portion. The main advantage of having this kind of plan is that it doesn’t come with a network, so you’ll be able to choose whichever dentist you want.
Preferred Provider Organization (PPO)
A PPO is one of the most common kinds of dental insurance plans out there. A dentist joins a PPO network and then negotiates his fee structure with the insurance company.
If you choose to use a dentist that’s out of the network, then you’ll end up paying more out of pocket.
These plans can be more expensive because of the administrative costs. However, you still get more flexibility than other plans.
Health Maintenance Organization (HMO)
When you have a health maintenance organization (HMO), you will pay annual or monthly premiums but you’ll be limited to the network. You might need to live within the area where the HMO is provided.
This is the cheapest kind of plan and dentists agree to charge fees for specific services.
3. Find Out if You Can Get Group Coverage
Most people get dental benefits through their job or other group coverage programs.. These plans tend to be less expensive than buying individual insurance.
However, you should look at the details of these plans and see if the benefits are worth the money.
4. Check Into Individual Policies
An individual insurance plan is going to be more expensive than a group one, whether you’re buying one for your whole family or just for yourself. And there are also some big drawbacks to this coverage.
These policies come with limited benefits, and insured parties usually need to wait before a major procedure can be approved. If you intend to sign up for a plan just because you need to get implants or some other procedure, you’ll be out of luck. Insurers are aware of that strategy and they usually employ a waiting period before you can start using certain benefits.
This waiting period can be up to one year, depending on what the procedure is.
5. Find Out Which Dentists Are in Your Network
If you have a dentist that you like, then you should ask them what plans they accept. An indemnity insurance plan will let you use the dentist you want but HMO and PPO plans limit you to certain dentists. If you don’t mind using a different dentist, then you may be better off with an HMO or PPO.
However, it’s possible that a new dentist will tell you that you need to get a lot of work done. If that’s the case, it’s always good to get a second opinion so you know you won’t be taken advantage of.
The Importance of Knowing About Dental Insurance Plans
Hopefully, after reading the above article, you now have a much better understanding of what dental insurance plans are and how they work. You should also now know how the various plans differ from one another. And this information should help you make more educated and confident purchasing decisions.
Are you looking for other helpful articles like this one? If you are, then you should definitely make sure to check out the rest of our blog today for even more!