Dental Insurance

In order to gain access to routine dental visits and major or minor dental work, you will need to obtain dental insurance. This coverage will help pay a portion of the costs associated with dental care. Unlike medical insurance, dental insurance policies are much more straightforward. In fact, most policies outline exactly what procedures are covered and what the out-of-pocket costs will be.

While you can obtain dental insurance through medical insurance plans, there are also stand-alone dental plans available to better fit your needs.

There are a variety of dental insurance plans to choose from, which is why it is important that you know how dental insurance works and what each type of dental plan can do for you. In addition to dental insurance, there are dental saving plans that can offer you considerable discounts on extensive procedures.

Understanding dental insurance can help you make an informed decision on which option will save you more money in the short and long-term. Read below to learn how dental insurance works, the different types of plans available and how to find the right plan for you.

How Dental Insurance Works

Dental insurance is intended to help reduce the costs of dental work, including preventative, major and minor procedures. For an individual to obtain dental insurance, he or she must pay a premium or an established monthly fee to a dental insurance company.

In addition to a premium, he or she must pay a deductible or a certain amount before the insurance plan begins to cover any dental costs.

This means that if the deductible is higher than a procedure, the procedure will not be covered by the insurance company. Once the deductible has been paid, the insurance provider can assist the individual with dental expenses.

However, he or she will be expected to pay a percentage of these costs, also known as co-insurance. As for preventative care, the bill will be covered entirely by the insurance provider.

Additionally, certain services will require a copayment or a fixed fee that is dependent on the type of dental plan. These services may include teeth cleanings, x-rays, fillings and more.

For those who have a standalone dental policy, there will typically be a waiting period before they can receive procedures. Depending on the policy, this can range from six to 12 months for standard procedures. For major dental work, the wait time can be up to two years.

Types of Dental Plans

Before you can choose the appropriate dental coverage, you must be aware of the different types of dental plans available. These plans have different conditions regarding the dentists you may receive treatment from and the costs related to each dental service.

While some plans require that you obtain care from dentists within a network, others allow you to receive care from any dentist you prefer. Depending on the insurance provider, you may receive access to the following plans:

  • Preferred Provider Organization (PPO): A care organization that provides members with a network of dentists and dental specialists contracted to provide services at lower rates. This is the most common dental insurance option due to its flexibility. Although choosing a dentist within a network is cheaper, policyholders have the option of choosing a dentist outside of the network as well.
  • Dental Health Maintenance Organizations (HMO): These plans are typically cheaper than PPOS and also have a network of contracted dentists. However, patients covered under these plans must choose a dentist from a pre-approved list or they will not be reimbursed for any amount paid out-of-pocket.
  • Dental Indemnity Insurance: Indemnity plans require that clients pay their dentists directly for the type of service they receive. After a patient pays the service, he or she will be reimbursed. This requires submitting claims forms which can take some time. Those insured under these plans can choose any dentist they would like and do not need a referral to see a specialist.

Insurance vs. Savings Plans

In addition to the three most common aforementioned plans, you can receive assistance with dental costs through a dental saving plan. If you are wondering how dental insurance and dental savings plans differ, the difference lies in the types of benefits available and the amount you pay for coverage.

While dental insurance consists of deductibles, co-insurance and copayments, dental savings plans do not. This is because a dental savings plan is not insurance, but rather a discount program.

Instead of paying a monthly premium, you will be expected to pay a membership fee that gives you access to care at a pre-negotiated, discounted fee. You will pay this reduced fee at the time of service for the type of service you receive.

In order to obtain these services at a discounted cost, you must receive care from a dentist that is part of the dental saving plan’s network. These discounts can range from 10 to 60 percent of an average procedure.

Finding the Right Dental Insurance Plan

Once you have developed an in-depth understanding of the types of dental coverages and options available, you can choose the best suitable option for you. If you have a particular dentist that you prefer, be sure to ask about the plans they accept and the services that they cover. This way, you can ensure that you continue to receive the care you want at the most affordable price.

If you do not have a dentist, then consider the type of coverage you need. Make sure to evaluate what each plan offers and whether the costs make sense for the type of services you need. The best ways to find and compare dental insurance plans are through independent insurance agents and online marketplaces.

Keep in mind that the benefits of each plan will vary based on the number of people you need to cover. Additionally, it is important to research the dentists in each network when searching for the right coverage. Keep in mind that you should also consider dental saving plans.