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Dental
Insurance |
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Dental insurance is proven to be a large factor
in the dramatic increase in oral health found
in every age bracket since the end of World War
II. Although advances in dentistry and the use
of additives like fluoride also deserve a great
deal of the credit for the drop in cavities seen
in the past six decades, the widespread availability
of dental insurance has certainly made it easier
and more affordable to keep the teeth clean and
healthy. |
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In truth, dental insurance is typically much simpler
to enroll in and use than most health insurance
programs. However, there are some very common
components to dental insurance that greatly resemble
terms used in health insurance plans, such as: |
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Deductibles |
Limitations on Services |
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Co-Pay Requirements |
Using Dentists from Participating |
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Annual Limits on Coverage |
Network |
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Deductibles |
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Just as with many health insurance plans,
participants may be asked to pay a deductible
before the dental insurance begins picking up
the tab. It is not uncommon to see a $50-100
deductible on most dental insurance programs
but you can definitely shop around to find those
with lower deductibles. However, lower deductibles
may come at the price of greater restrictions
on procedures or perhaps a lower overall annual
coverage. |
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Copay
requirements |
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Co-pay requirements are not as common
in dental insurance plans but some do require
them. As with the health insurance plans, a small
fee will be required at each office visit if the
plan dictates. However, this is not common so
be sure to shop around if your plan is requiring
co-pay along with a deductible. |
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Annual
limit |
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Most dental insurance plans will set a
pre-determined limit on the maximum amount of
coverage they will extend to an enrollee. The
average annual limit for dental insurance is averaging
$1,000 with the better plans having higher limits.
However, this amount is typically disbursed during
one calendar year. Thus, if you had $1,000 worth
of approved dental work performed in December,
it is often possible to again reach the maximum
for the coverage in January—essentially
receive $2,000 worth of services in a two month
span. However, you will then not be eligible for
any coverage until the following January and this
option may not be possible under all plans. |
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Unapproved
Procedures |
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In the vast majority of cases, dental insurance
will not cover pre-existing conditions or cosmetic
procedures. Dental insurance will cover office
visits and the treatment of problems that arise
after the beginning of the policy, but prior dental
health issues will not often be covered. |
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Braces, dentures, crowns, and other such dental
services are rarely covered by dental insurance
as they are considered cosmetic. However, if the
teeth are decaying, the insurance will pay to
have them extracted (if the problem reasonably
arose during the period of coverage) but the patient
would likely be responsible for the actual dentures.
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If there is one section that you really need to
review carefully before signing up with any dental
insurance plan, it is the one covering “approved
procedures” or “what’s covered”.
By the time a deductible is taken into account
and any possible co-pays, the benefits of dental
insurance may not be as great as you think. However,
for maintaining good oral health at the lowest
possible cost, there is no doubt that dental insurance
is invaluable. |
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| Dentists
from Approved Network |
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Much like a PPO or HMO, dental insurance often
uses dentists from a network and asks enrollees
to select providers from a list. For those accustomed
to seeing their own dentist, this requirement
can really be a hassle and quite uncomfortable.
However, this is one of the trade-offs that comes
from the lowered costs of using dental insurance.
You can possibly buy dental insurance on your
own and then continue to see your regular dentist
but it may cost you 20% or more than that provided
by an employer. Again, there are always some trade-offs. |
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