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Understanding Dental Insurance Benefits

Understanding Dental Insurance Benefits

If you’ve been paying out of pocket for dental care for you and your family, you may be interested in ways to cut costs.  You may have heard of dental insurance, but never really understood how it works, and how it can ultimately save you money.

While dental insurance is often referred to as “insurance,” it doesn’t really work in the same way as a health insurance policy, or homeowner’s policy.  This is why there has always been a bit of confusion about dental insurance, and how it works.

Dental Insurance or Coupon Program?

Instead of thinking of dental insurance as a way to pool risk, or protect you from unforeseen circumstances, it’s better to think of it as merely as a discount coupon.  Dental insurance is simply a way for employers, and individuals to offset some of the costs related to their dental care.

What Types of Dental Insurance Exist

  • Dental Health Maintenance Organizations (DHMOs) – DHMOs are prepaid dental plans, that offer low premiums, give you significant discounts on dental care, cover pre-existing conditions and usually have no annual spending limit.
  • Preferred Provider Organizations (PPOs) – With a PPO, you do have an annual cap on coverage, and plan members will need to pay a higher percentage of copays than they would if they were in a prepaid plan. Deductibles for a PPO will likely run you $50 for an individual plan, or $150 for a family plan.  One benefit of a PPO is that the majority of dentists will accept a PPO plan, but all may not accept a DHMO plan.
  • Dental Indemnity Insurance – These types of plans are also known as “fee-for-service plans,” and are typically not offered by every insurer. These plans typically have low or zero deductibles, higher annual caps and allow you to see a large variety of different dentists.  Premiums for these plans are often higher than both PPOs and DHMOs.

Are You Looking For A Dentist?

If you already have a dentist that you love, it’s worth asking them if they accept any forms of dental insurance.  If they do, great, you can sign up for one of those plans.  If they don’t you may need to think through whether you would be ok with switching dentists to someone that would take whatever type of dental insurance, you choose to purchase.

Pre-Existing Conditions and Dental Insurance

Don’t make the assumption that because you’ve been putting off an expensive root canal, or crown you can simply signup for dental insurance and have the problem fixed right away.   Most dental insurance plans will have significant waiting periods before you’re able to be reimbursed for major dental procedures like root canals, bridges or crowns.

Know Your Dental Insurance Limits

With typical healthcare insurance, you’ll have a deductible and then after you’ve paid it, your health coverage will kick in.  With dental insurance this is not the case.  Instead, you’ll have coverage only up to a certain limit, which is usually between $1000-$1500 each year.  Any expenses that are over and above this limit must be paid out of pocket, in addition to your dental insurance premiums.

If you think about the high costs of some procedures like root canals, or crowns, you can quickly eat up your coverage limit with one or two major procedures.  This is something to keep in mind when deciding whether or not to buy dental insurance.

Dental Insurance is Good – for Some

The reality is that dental insurance may not be for everyone.  If your employer offers dental insurance, it is definitely worth looking into or if you’d rather spread out the cost of your dental treatment over the course of a year, dental insurance may be for you.  If not, you may be better off getting a dental savings plans – plans are available to you through providers like Aetna, Cigna and Careington among others.

Dental Savings Plan or Dental Insurance

With dental savings plans you simply pay a yearly fee for discounted dental services.  You’ll need to determine if your dentist participates in a dental savings plan, and if so you can quickly see how much you’ll save by using this type of plan as opposed to dental insurance.  Dental savings plans can regularly save patients up to 10%-60% off their regular dental visits.  For more information on a wide array of dental savings plans, as well as to determine which dentists in your area accept these plans, feel free to browse our website today.

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