Most people don’t pay attention to dental care because they don’t have dental insurance and dental treatment comes at a cost. That’s why most people ignore dental problems and don’t like to pay for much-needed doctor’s visits. Dental insurance is made for you if you are one of these people. Good dental insurance covers most preventive services and other dental care.
Here is everything you need to know about dental insurance and what it covers.
Are Dental Insurances Same as Health Insurances?
Dental insurance is not like medical insurance. For example, if a deductible is met, the insurance will not cover the remainder of the cost like health insurance would. Dental insurance covers certain costs of your dental health expenditure. The major difference between both insurances lies in the nature of the problems they cover. Medical insurance covers reactive treatment, i.e. treatment for existing illness. Dental insurance focuses on preventive care. Thus, it provides 100 per cent coverage on preventive treatment such as cleanings and routine dental exams.
What Is Dental Insurance Coverage?
Every insurance is different, and it depends on the policy you opt for. Most insurance coverages follow a 100-80-50 ratio, i.e., 100% coverage for some costs, 80% for others, and 50% for the rest. Also, cosmetic dentistry is not covered by dental insurance.
For services like cleanings, x-rays, and dental exams, 100% coverage is available.
For basic treatment like a root canal, fillings, periodontal cleaning, and other minor services, 80% coverage is available.
For major restorative services like crowns, dentures, bridges, extractions, surgeries, etc., only 50% coverage is available.
Types Of Dental Insurance
Learn about these types of dental insurance plans before you agree to buy one from your agent.
Preferred Provider Organization (PPO)
This type of dental plan offers you a network of dentists. The dentists in a network negotiate their fee structure; based on it; the insurers offer you annual coverage. You get an annual deductible and also sometimes need to pay a co-insurance. If you go for a dentist out of your network, you will have to incur out-of-pocket expenses.
Health Maintenance Organizations
Health Maintenance Organizations are locally based, and this type of dental insurance plan offers you a smaller network to choose a dentist from. You choose a dentist from the provided list when choosing your plan. It also requires monthly or annual premiums, which are generally low. But, again, if you visit a doctor out of the network, you will have to pay more out of your pocket.
This type of plan is simple. You incur expenses and then claim them from the insurance company. But the problem is that you need money upfront to pay for the expenses. The insurance company limits the reimbursement it will pay against every expense. The benefit is that you can choose any dentist of your choice. Also, the company must approve your claim to reimburse you in this case.
Important facts About Dental Insurance
There are some important things that you must know about dental insurance.
Preventive Care Insurance
Dental insurance is aimed to provide basic dental care to all. It is not for luxurious treatments such as cosmetic dentistry or teeth whitening. Instead, it is meant for preventive care, including x-rays, cleaning, and basic dental checkups.
Medicare Does Not Cover Dental Care
Medicare is different, and dental insurance is different. Dental care is not included in medicare. However, many companies are offering special medicare plans covering essential dental services like checkups and exams.
There Are Incidental Expenses
When you choose a plan, understand its fine lines. Unless it is a full-coverage plan, you may have to incur other expenses as well. Say, if you opted for a PPO and visited a dentist out of the network, you will be required to pay out of pocket.
No Cosmetic Dentistry Is Included
Cosmetic dentistry includes procedures that aim toward beautifying your smile. It generally includes veneers, teeth whitening procedures, dental implants, etc. Since these are not preventive care services, your dental insurance will not cover these. However, some companies are offering exclusive dental implant insurance these days. Some examples are Delta Dental PPO Plan, Spirit Dental & Vision, Ameritas, etc.
Longer Waiting Periods
You can’t purchase a dental insurance policy today and get major surgery tomorrow. There is a waiting period for it. For preventive care services, the waiting period is comparatively short. However, basic and major restorative services have a longer waiting period which may last several months. So, if you are planning a major dental procedure in the future, choose a dentist in chandler and a dental insurance policy now.
Missing Tooth Clause
When you buy a dental insurance plan, check if it has a missing tooth clause. The clause states that, if the patient is missing a tooth before the contract begins, the cost incurred on the treatment like capping, crowning or bridging will not be reimbursed by the insurance company. Employers also insert this clause in the employee dental insurance contract.
The clause is inserted to protect the insurance company because the cost of these procedures is on the higher side. Thus, you must read your dental plan document carefully.
There are also other restrictions some employers include in the dental plans they provide their employees. Things such as a “missing tooth clause” which prohibits any payment for treatment to replace a tooth that was missing prior to acquiring the dental insurance.
Why is Dental Insurance A Must?
The uncertainty of life makes it imperative that you plan for the future. Dental care is not a luxury but a basic necessity. You should get your teeth examined every six months, even if you don’t have a dental problem. Dental insurance is a must to cover the costs of expected and unexpected visits. Your insurance will absorb the shock. Dental emergencies are not new. Insurance will protect you from sudden financial risk.
There are thousands of dental insurances available in the market. But you must do your research, and based on your requirement, you must choose a dental insurance plan which suits you.