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6 Facts About Dental Insurance

6 Facts About Dental Insurance

Health insurance helps you afford treatment for injuries and illnesses. Auto insurance helps you afford repairs for vehicle-related damages. But does dental insurance really help you afford quality dental care?

Dental insurance isn’t like any other type of insurance. For some situations, dental insurance makes a lot of financial sense. However, dental insurance also has some drawbacks you’ll want to consider.

Here are six quick facts to help you determine whether dental insurance is right for you:

1. Current Dental Problems Typically Aren’t Covered

Dental insurance is almost never a quick way to fix any dental problems you have right now. Insurance policies typically have a few tiers of waiting periods before coverage beings. You’ll usually be able to use your dental insurance right away for cleanings, exams and similar procedures. But you’ll have to wait anywhere from six months to a year until insurance will cover most minor and major dental procedures.

Additionally, dental policies typically don’t apply to pre-existing conditions such as loose or cracked teeth. Also, a “missing tooth clause” often applies, which means no coverage for issues related to any teeth which were missing prior to the policy purchase, no matter how long you wait.

2. Dental Insurance Offers Three Levels of Coverage

Most dental insurance will cover 100% of all preventative care. This typically includes twice yearly visits to the dentist for a check-up and cleaning. Preventing dental problems isn’t just the best option for your health, it makes the most financial sense for both you and the insurance company.

Next are minor procedures, which include fillings, deep cleanings for gum care and other relatively simple procedures. Minor procedures will turn into serious issues without treatment. Most dental policies cover 80% of the costs of basic procedures.

Finally, major dental treatments are covered at 50%. These are extensive procedures such as root canals, as well as the creation of any unique appliances like bridges or dentures. Keep in mind many serious dental issues take a long time to develop. You may not be covered if the issue originally developed before you purchased a policy.

3. Dental Insurance Has Annual Limits

Not every eligible procedure is necessarily covered by your policy. Typically, dental insurance has a limit between $1,000 and $1,500 for the year. Once that limit is reached, you’ll have to pay out of pocket for your dental care, until your policy renews.

Sadly, the annual limit is pretty easy to reach. If you need extensive dental work, you might have to split the procedures across two years or more. Plus, even if you reach your limit, you’ll still have to pay premiums on your policy each month until the end of the year.

4. Dental Insurance Limits Who You Can See

Your insurance may require you to see a dentist within the insurance company’s network. The two most common types of insurance plans are a Dental Health Maintenance Organization or a Dental Preferred Provider Organization. With a DHMO, you must see an assigned, in-network dentist. With A DPPO, you’ll save the most if you stay in-network.

There is another type of dental insurance called either dental indemnity or a fee-for-service plan. These plans let you visit any dentist you like. On the downside, premiums are much higher than other types of plans, and you pay the full cost of treatment to your dentist and then are reimbursed for a portion of what you paid.

5. Dental Insurance Often Improves Oral Health

Dental insurance can seem restrictive in a lot of ways, but there are also benefits to having a policy. Mainly, dental insurance can be helpful at preventing problems. Complete coverage takes the financial worry out of scheduling dental check-ups and cleanings, which are essential for maintaining good oral health.

6. Dental Insurance Isn’t the Only Option

Car and health insurance are legally mandated. But you’re under no legal obligation to have dental insurance. Roughly one-third of all American’s have no dental insurance at all.

However, unlike health and auto insurance, there are alternatives to dental insurance. One of the most popular alternatives is a dental discount plan, which isn’t dental insurance, but does offer a variety of ways to save on dental care.

Plan members pay an annual fee for access to savings between 15% and 50% on a wide variety of dental procedures. After joining a plan, you’ll be given a membership card which you simply present at the time of service for instant savings. Over 110,000 dentists nationwide accept dental discount plans. Plus, dental discount plans have no annual limits. Discounts are even available for dental conditions you had before you purchased the plan — no “missing tooth clause” here.

Dental insurance can help make dental care more affordable, but be sure you understand the facts. For many people, a dental discount plan provides not just savings, but also peace of mind.


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