What Does My Dental Insurance Actually Cover

Isn’t that true that most of us take other people at face value? The first thing which almost majority of you notice in someone is their face, including their teeth.

So, are you valuable enough to buy a dental insurance plan if you don’t have one? Fundamentally, dental insurance premiums can be more expensive than just paying out of your pocket for routine checkups as well as cleaning.

Dental Insurance

Well! Most dental policies emphasize prevention and diagnostics, which mainly covers two annual exams and cleaning, X-rays and much more. However, most of the dental insurance policy doesn’t give you 100% coverage. So, a big question arises that what does dental insurance actually cover?

We have answers for all the questions arising in your mind. Just stick to this post and get answers to all your questions.

Types of Dental Insurance Plans

Dental plans are quite similar to health insurance plans; however, in some aspects they are different. In general, you have the following types of dental insurance plans.

1. Preferred Provider Organisation {PPO}

PPO or Preferred Provider Organisation which comes with a list of dentists that accept the plan. Moreover, with PPO you can also get treatment outside of the network as well; however, you have to pay for the cost.

2. Dental Health Maintenance Organisation {DHMO}

Dental Health Maintenance Organisation is like a health insurance HMO, these plans provide a network of dentists which accept your plan for pre-settled co-payment, and you don’t have to pay the fee at all. However, you cannot see an out-of-network dentist with DHMO plan.

3. Discount or Referral Dental Plan

Discount or Referral Dental Insurance plan is a type of plan which offers you to get a discount on dental services from a selected group of dentists. Dissimilar health insurance, the discount or referral plan doesn’t pay anything for your care. Preferably, the dentists who participate agree to give you a discount on the care you receive.

What to Consider Before you Buy Dental Plan

Now, before getting into the Network of participating dentists always check that your dentist comes in the plan or if your dentist is not in the plan then your plan offers you to see a dentist outside the network.

Moreover, your dentist may be able to recommend a plan based on your dental history. Here we have mentioned some of the important points which you must consider before buying any dental insurance plan.

  1. Your dentist or specialist is in your dental plan network.
  2. Check total costs for the plan each year, including premiums, co-pays as well as deductibles.
  3. Check your out-of-pocket budget limit, if you have any.
  4. The limitations on pre-existing conditions.

5. Does your plan has emergency treatment coverage, including treatment if you’re far away from home.

So, do consider all these points before buying your next dental insurance plan. With the help of the right research, you can find affordable dental plans. Also, check this teeth whitening by soothing dental.

What does your Dental Insurance Plan Cover?

So, a lot of you have a question that what does my dental plan cover and how it benefits you.

In general dental policies cover some portions of the cost of preventive care, fillings, crown, root canals, as well as oral surgery which includes tooth extractions. Your dental insurance plan may also cover orthodontics, periodontics, and prosthodontics, like as dentures and bridges.

Furthermore, your dental insurance plan usually covered for two preventive visits per year. Now, if you got an individual policy, periodontics and prosthodontics might not be covered in the first year. Basically, Orthodontics requires a rider, in which you only have to pay for an additional fee, for any policy.

The majority of plans follow the 100-80-50 coverage structure. These coverage structures imply that they cover preventive care at 100%, necessary procedures at 80%, and significant procedures at 50%. However, a dental insurance plan may elect not to cover some procedures, including sealants at all. Every dental insurance plan has a cap on what it will pay during the plan year, and for most of that cap is quite lower.

You have to pay for all the expenses that go beyond that amount. More than half of the dental PPO’s only offer annual maximums of less than $1500. Now, if you have a plan with $1500 limit then, you are responsible for all expenses above $1500. If you want a crown, a root canal, or oral surgery, then you can reach the maximum quickly.

“There’s generally separate lifetime maximum for orthodontics costs.”

Is there any Alternatives to Insurance which gives complete coverage?

A typical dental insurance plan doesn’t meet all your needs; however, if you’re looking for dental insurance which gives you a complete coverage than be aware that the premiums for indemnity dental insurance are expensive.

The plan which has a $2500 annual cap on coverage, the average monthly premium is $65-$70 a year for an individual. However, a typical cost of a preferred provider for an individual dental insurance policy around $350 a year.

Furthermore, you may not get the discounted rates on your dental services that insurance provider directly negotiate with the dentists who are the part of the provider’s network. This negotiation with dentists can make your costs considerably less expensive around 30% to 60%.

Now as you look into dental insurance and other ways of paying or dental care, you may find that dental saving plans offer more flexible as well as affordable premiums.

Dental saving plans mainly offers discounts from 10 % to 60% on average dental care costs, it doesn’t have annual caps, no waiting period is applied for accessing care, and there are no restrictions on obtaining care for preexisting conditions.

The Conclusion

With the help of right research, you can easily able to choose the dental insurance plan which meets all your dental needs. So, before choosing a dental plan make sure you have researched well and know that what your dental insurance plan covers.

Apart from that you must also search for the network of participating dentists and find that whether your dentist is in the network or not.

If you have any queries related to dental insurance coverage, do let us know in the comment section. We would be happy to assist you. Till then keep smiling.

Leave a Comment

Your email address will not be published. Required fields are marked *