If you’re reading this, you may be hoping to find the name of a few dental insurance providers and be on your way. But, that wouldn’t be doing you any service because dental insurance providers and dental insurance plans aren’t one-size-fits-all. What one person considers the best dental health plan may not be a good fit for the next person. That’s because the word “best” can be subjective. Here are three scenarios to help explain it in terms of dental insurance.
Preventive, DPPO, and DHMO dental insurance
Imagine that Bobby signs up for preventive-only dental insurance. It covers preventive and diagnostic services, like oral exams, x-rays, cleanings, fluoride applications and sealants at 100% if he visits an in-network dentist. If he needs additional dental work done, he will likely pay 100% of the dental provider’s contracted fee.
Now imagine that Becky signs up for a dental HMO plan that only costs her $16 a month and has no annual maximum. It seems like a great deal until she realizes her long-time dentist is out-of-network. In order to keep her dental costs as low as possible, she has to switch to an in-network dentist.
Becky’s twin sister Betty, however, opts for a dental PPO plan. It costs $26 a month and allows her to see any dentist she wants but her plan only pays $1200 a year toward the dental work she needs done. After that, she’s on her own.
Who do you think picked the best dental health plan? Maybe you think Bobby did, because you only visit the dentist for checkups twice a year too, so that plan seems perfect. Perhaps you think Becky did because budgeting $16 a month for dental insurance sounds pretty good, even if you have to switch dentists. Or, maybe you think it’s worth Betty paying a higher monthly premium for dental insurance because she has the freedom to see who she wants. Plus a $1200 annual maximum is enough to cover the work you need done.
What to look for when signing up for dental insurance
When it comes to picking the best dental health plan, it really boils down to what is most important to you. Is it the overall value, the convenience, or the dental insurance’s terms and conditions? Maybe it’s a combination of all three things.
Value is pricing. This is how much you can expect to pay or save with your dental insurance. If your premium is $26 a month that means you’ll pay $312 for a year of dental coverage. If you only use your dental insurance for cleanings two times a year, and they cost $75 each without insurance, you’re paying more by having dental coverage so the value drops. On the flipside, if you know you need a root canal and an extraction, having dental insurance can work in your favor by helping offset your out-of-pocket expenses.
Convenience is about ease of experience. It means you have access to a large number of in-network dentists who are close by, your dental insurance provider is easy to work with, allows you to view and track your claims online, makes your policy easy to understand, and provides a good customer experience overall.
Terms and conditions are things like waiting periods, deductibles, annual maximums, and how frequently dental insurance will cover cleanings and x-rays. All of these things can vary widely, or may not even be relevant, depending on the type of dental insurance plan you choose.
To get started finding the best dental health plan for you, first, estimate your dental care needs. A good predictor of future dental care needs is past dental care needs, so use that as a go-by. If you know you need – or will probably need – a root canal, for example, look at the fee schedules from a few dental insurance companies to get an idea of costs. Fee Schedules are a list of typical prices for dental treatments, along with the fee that an insurance company has negotiated for those treatments, and what percentage of that fee you are responsible for paying. For example, a dentist might charge $800 for a root canal, the insurance company has negotiated a rate of $650, and your insurance coverage pays half the cost. You are reasonable for paying your dentist $325 for the root canal.
Next, read through dental insurance plan brochures to learn about the terms and conditions of each plan you are considering. How long to you have to wait before you’re covered for more expensive procedures (typically the waiting period is 6-12 months). What treatments are excluded? Are there limits on getting particular types of treatment? Don’t be afraid to call customer service with any questions you have. This will give you great insight into what it’s like to be a customer before signing up.
Finally, using an A, B, or C, grade the dental insurance companies you’ve researched on the three key areas we talked about above — value, convenience, and terms and conditions.
Alternatives to dental insurance
During your research to find the best dental health plan, you’ll probably come across an alternative to dental insurance known as a dental savings plans. This is a popular option for many people because dental savings plans are affordable, flexible and have several attractive features.
The way a dental savings plan operates is like a club membership. The annual membership allows you to get discounts of 10% to 60% on most dental procedures when you visit an in-network dentist. Plus, with a dental savings plan, you don’t have to worry about waiting periods, deductibles, coinsurance, annual maximums or insurance paperwork.
Dental coverage options
Now you know some key things to look at when evaluating dental insurance plans, as well as some unique advantages of joining a dental savings plan. Research and grade a few different dental insurance companies and dental savings plans to find the best dental coverage option for you.