Dental Guides

What you should know about dental insurance

Dental insurance is designed to meet part of the cost for dental care. This type of heath insurance comes in various packages such as family, group or individual insurance plans.

Just like life insurance dental plans should offer peace of mind to patients since the cost of dentistry often makes people anxious thus keeping them away from dentists for years at a time. Since dental care is important it is best to choose an insurance plan that covers the dental care required by you and your family. You may also need to consider whether the person or persons to be covered require special care such as dentures, tooth implants, orthodontia, bridges and crowns.

The insurance plans are further divided into 3 categories which are:

Indemnity insurance plan: This health insurance is ideal when you want to stick with your dentist who prefers not to take part in any dental network. The plan is designed in a way that requires the insurance company to basically pay the dentist a portion of your dental care according to the policy purchased.

Dental health managed organizations: Basically when a dentist signs a contract with a dental insurance provider the company agrees to accept the responsibility of scheduled insurance fees and offer their customers reduced cost for In-Network Provider. Most of these plans have little or no waiting periods as well as no maximum benefits limits especially when covering major dental procedures at the beginning of the policy period. Patients opt to buy this plan in order to defray expensive dental procedures

Preferred provider network dental plans: It depends on your specific plan and works similarly to DHMO while using an In-Network facility. The plan allows the client to use Non-participating or Out-Of -Network provider. Any fee difference is footed by the client unless it is clearly stated in the dental policy. Some plans may have maximum benefit limits calculated annually. This means that once the patient exhausts the maximum benefit additional treatments will be absorbed by him or her. 

Generally dental insurance plans include:

Emergency care: This covers instances such as extractions, broken tooth repair or treatment after an accident which involved the mouth and teeth.

Routine and preventive care: It includes periodic checkups, x-rays, fillings, cleanings and some types of oral surgery. It also covers root canals and gum care.

Complex care: This covers orthodontia, bridges and dentures. Most dental plans cover part of the cost of these types of procedures.

The affordability of any plan is usually based on premium payments. While a HMO may mean less money is deducted from your paycheck the patient will end up footing more dental care bills involving complex treatments such as implants, braces or bridges. This may not be the bargain that you had in mind when purchasing a dental plan. On the other hand buying a high premium policy for freedom-of-choice plan when you have uncomplicated dental history may be considered as overkill.

It is important to visit a dentist and undergo an exam that includes several diagnostic x-rays before purchasing a dental insurance plan. The dentist will assess your general dental status and determine if you need any complex procedures. The assessment is also meant to guide you on what level of insurance would be best to cover your needs.


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