10 Things You Need to Know About Dental Insurance

Oct 6, 2015

There are many benefits to medical insurance. Unfortunately, most medical plans do not cover dental. Routine teeth cleaning and more extensive dental work is important medical care, and an individual should be sure to get dental coverage.

That said, there are factors to consider when looking at dental insurance. Here are the top 10 things you should know when looking at dental insurance:

1. Dental plans have a variety of limits. For example, your plan may limit you and your family to a specific number of exams or only one full set of x-rays every 36-60 months.

2. Many dental plans will have a waiting period during which you must pay for the plan, but you are not covered to receive specific services. So, if you need those dental services during the waiting period, you will have to pay for them out of pocket.

3. Some plans have an “alternate benefit” provision. This is when the plan will not cover the service your dentist proposes, but covers a lower cost dental service that ends up with a similar result. For example, the plan may only cover amalgam fillings instead of composite fillings. If you want to get a composite (tooth-colored) filling, you will have to pay more out-of-pocket.

4. There are plans that will only pay a percentage of your dental services. If you need more than routine dental maintenance, a Dental PPO will almost certainly require that you cover a percentage of the cost out of pocket. Dental HMO’s often require co-pay.

5. Both PPO and HMO dental insurance will likely require that you pay a deductible. This means that there will be out of pocket expenses associated with some dental procedures.

6. There are many types of dental plans. Some are traditional PPO and HMO plans. Others, like a Dental Indemnity plan, will allow you to choose the dentist you want, but will have a cap on how much you can spend per year on your dental needs. Be sure to thoroughly research the benefits and pitfalls of each plan before deciding what is best for you.

7. A Dental Discount Plan is not insurance. Instead, it is a plan that has contracted with a network of dental providers to give you care at a discounted rate.

8. Many dental insurance plans have a dispute resolution mechanism set up so that disputes between dentists and patients can be resolved without court costs.

9. While dental insurance generally isn’t addressed by the Affordable Care Act, children’s dental coverage is, so be sure to look at what benefits your children are allowed under your health insurance before buying dental insurance for them as well.

10. Some dental insurance plans have prior injury-type clauses. This could be a “missing tooth” clause, which won’t cover dental work on a tooth lost before coverage was started. Be sure to review this information carefully before deciding on a dental plan.

Dental work is an important part of overall healthcare. Be sure to review a variety of dental plans thoroughly before deciding on the right plan for you and your family. We offer insurance solutions right here at IBG, so if you have questions about how to keep those pearly whites shining, contact us today.

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