Affordable Dental Insurance
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About Dental Insurance
With the rising cost of dental care, people in the U.S. often struggle to get the required treatment. Therefore to maintain a great smile people need to have dental insurance that covers issues related to the teeth and gums as well as also include preventive care like annual cleanings. Dental insurance is designed to provide coverage for some of the common dental issues, which allow individuals to budget for dental services at preventive, basic and major levels. These plans help you opt for the expensive dental treatments, as these plans cover 100% of the cost of preventive care like x-rays, checkups and cleanings, 80% of basic treatments like fillings and 50% of complex procedures like crowns and root canals. Coverage of your dental plans begin after you pay your deductible that is usually $50-$150 annually. Deductibles, co-pays, and co-insurance apply for dental insurance. Majority of the dental policies have cap the annual out-of-pocket maximums that typically range from $750 to $2,000 per year. With the higher monthly premium one gets higher the yearly maximum. On reaching the yearly maximum, patients need to pay the entire amount of any remaining dental procedures. Dental insurance plans come with no age restrictions, as these plans offer coverage for every age group and in every stage of life. Some of the health plans include dental coverage and if you want dental coverage and it is not included in your health plan then you can enroll in a stand-alone dental plan.
Dental Coverage is Available in Two-Ways
Dental insurance can be availed from the insurance marketplace either as a part of a health plan or one can by itself through a separate, stand-alone dental plan.
Health Plans that include dental coverage – In some of the health plans dental coverage is included and one can select the plans that include dental coverage.
Separate stand-alone dental plans – Stand-alone dental plans are offered in the marketplace and if you choose a separate dental plan you need to pay additional premium.
Types of Dental Plans
Individuals looking for dental insurance plans must have good understanding of different dental plans so that they are able to take best dental plan that suits their requirements and prevent surprises.
Employer-sponsored plan is an example of group plan and the best thing about this plan is that there is no waiting period in a group plan. Individuals taking group dental plan enjoy the same privilege that is offered in a company-based plan and there is no waiting period for at least preventative services.
Preferred Provider Organization
Preferred provider is referred to a dentist who is in the insurer’s network and it is advantageous to visit any dentist of the network. Preferred Provider Organization dental insurance plan works similar to a DHMO plan, where members are allowed to avail dental care from the In-Network facility. However, members are allowed to avail dental care from a non-participating dentist but the difference of fees will become their financial responsibility unless it is specified in their dental policy. Some PPO dental insurance plans have annual maximum benefit limit and once this annual maximum benefit is exhausted, cost of any additional treatments become the member’s responsibility.
Individuals enrolled in this plan need to pay reduce fee to avail dental care from in-network or preferred dental care providers. However, it is not essential to see in-network providers but insured save money when they visit in-network dentists. This plan is best for individuals who don’t require dental treatment right away but who want to be prepared for the future. Individuals who like some flexibility in their choice of dental care providers and at the same time do not want to pay high premiums will prefer this plan.
Indemnity or Fee-for-service Plans
Individuals enrolled in this plan are allowed to pick a dental care provider and their plan pays a percentage of the dental care provider’s fee. This plan has a wide array of dental care providers from which an individual can choose a dentist of their choice. This plan may have lower deductible and the higher annual maximum coverage limit. This plan is ideal for individuals who wish to visit certain dentists or who anticipate some costly dental procedures.
Dental Health Maintenance Organization Plans
Individuals enrolled in this plan are allowed to visit dentists included in the insurance network. Preventive services like cleanings and x-rays are 100% covered while some basic dental procedures come with a co-pay. In the HMO dental insurance plans, members need to avail dental care from dentists available within the network. Members can visit specialists only if it is referred by the primary dentist. There is no waiting period in this plan for the coverage to starts but this plan limit the number of times the members can see a dentist annually.
Discount Dental Plan
These plans are not technically insurance but these are organizations that have negotiated discounted prices with dentists who are included in their network. The individuals need to pay an annual fee to have access to their services at reduced rates.
FAQ on Dental Insurance
Yes, it is necessary to buy dental insurance, simply because like general health care dental care is expensive too. Besides, individuals should know that oral health plays an important role in one’s overall health, and without dental insurance individuals often avoid visiting to their dentist. On the other hand, dental insurance plans are quite affordable and low in cost and most of the plans pay 100% for check-ups every six-month, so individuals with dental plans start benefitting right away. Moreover, several dental procedures like oral surgery, getting a full set of dentures, requiring a crown can prove expensive, so having a dental plan will financially help people to manage these dental procedures.
Generally, there are four types of dental plans available such as DHMO, PPO, Indemnity dental plans, and discount dental plans.
A DHMO is a type of managed care plan in which a network of highly qualified dentists provides comprehensive and affordable care for individuals or families.
PPO dental plans is also a managed care plan also called a preferred provider organization. Members of this plan select a dentist from a network of preferred dental providers agreeing to provide dental care to members at reduced rates.
A dental indemnity plan allows members to choose from the largest pool of dentists, as members are free to visit any dentist, unlike the managed care plans.
Discount dental plans are not insurance but help consumers save on dental care costs. Members need to make a monthly or annual payments to receive unlimited dental care services at discounted prices based on a fee schedule.
Yes, dental insurance is a standalone coverage and you don’t need to have any other type of health insurance to purchase dental insurance.
It is not mandatory for anyone to have dental insurance as per the Affordable Care Act. Obamacare doesn’t require anyone to have dental coverage and no one will fact tax penalties if they don’t have dental insurance.
Individuals having dental plan need to pay a monthly premium to buy a dental plan. However, before their plan start paying for the covered dental services, individuals are required to pay their deductible amount, which they have to pay out-of-pocket. Dental plans may include a fixed copay for a certain service like an X-ray. Besides premium, deductible, and copays, individuals having dental insurance also need to pay coinsurance, which is a certain percentage the insured have to pay for the covered expenses after meeting their deductibles
Dental insurance plans come with annual maximums, which is the maximum that the insurer will cover in a given calendar year. However, the maximums depend on the plan and the insurance provider. Some dental plans are available with maximums that range from $1,000 to $3,000 annually.
Most of the dental plans available in the market provide coverage for dental work like extractions, fillings, and root canals. Though dental services covered and the amount the dental insurance company will pay vary plan to plan. However, individuals should ensure that the dental plan is the best choice for them by checking the plan details before buying the plan.