Top 10 Best Dental Insurance – Let’s face it: getting dental work done can be expensive. Even the most basic cleaning can put a dent in your pocketbook. Having comprehensive dental insurance can mean the difference between having important oral health care or living with gum problems or oral cavities. However, due to the way some policies are designed, you may be limited in what work you can complete.
Some people put off care because their insurance doesn’t cover the treatment, while others do so because they’ve used up their maximum coverage for the year. Still, most people agree that having some coverage is better than none. So how do you get started? Here are four important steps to take when purchasing dental insurance to avoid getting caught with unexpected expenses.
Top 10 Best Dental Insurance
Dental insurance gives you coverage to help pay for some dental work. These policies can help insurers pay for all or part of the work their dentist performs, from routine cleanings and X-rays to more complex ones like implants.
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Although dental insurance works a bit like health insurance, the premiums are usually lower—but, of course, there’s a catch. Most health insurance policies cover a high percentage of costs once your deductible is paid, and many have an annual out-of-pocket deductible of $50 to $100. This is not the case with dental insurance which usually follows a 100-80-50 coverage structure.
If you use an in-network dentist, dental plans usually pay 100% of preventive care—exams, X-rays, and cleanings. However, basic procedures such as fillings, root canals and extractions pay only 80%, while major procedures such as crowns, bridges, implants and gum-disease treatments may cost only 50%. Orthodontia and cosmetic dentistry, which are not considered medically necessary treatments, are generally not all-inclusive. This means you have to pay an even higher price to get your work done.
Older individuals in particular can benefit from the protections offered by dental insurance. Dental insurance for seniors focuses on the types of coverage older adults need. These include crowns, root canals, dentures and tooth replacements. Although these procedures are not unique to elderly patients, seniors may require one or more of them. Note that seniors on Medicare may need a different dental insurance plan than those without it.
These plans are very expensive and not common in the market. They are often called “fee-for-service plans”. Insurers limit the amount of money they pay for various procedures to common and conventional amounts set by the American Dental Association. If your dentist charges a higher amount, you will have to pay this amount out of pocket.
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Most insurance companies that offer indemnity plans require you to pay the full cost and file a claim. After the claim is approved, the insurance company will reimburse you its portion. The main advantage of having this type of plan is that it does not come with a network, so you are free to choose any dentist you like.
One of the most common types of plans available is a Preferred Provider Organization (PPO). Dentists join a PPO network and negotiate their fee structure with the insurer. If you decide to use an out-of-network provider, you’ll pay more out-of-pocket.
These plans can be more expensive due to the associated administrative costs. Still, they provide more flexibility than other plans, as they usually come with a wider network.
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With a health maintenance organization (HMO), you pay monthly or annual premiums but are restricted to a network, and you may have to live in an HMO-serving area. This is usually the cheapest of the three types of plans, with dentists agreeing to charge for specific services.
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Most people with dental insurance have benefits through their employer or AARP, other group coverage programs such as Affordable Care Act Marketplace health insurance policies, or public programs such as Medicaid, the Children’s Health Insurance Program (CHIP), and TriCare for the military.
These plans are generally less expensive than purchasing individual insurance and may have better benefits. However, you should take a good look at the details of an employer-sponsored plan to determine whether the premiums are worth the money for someone in your situation.
While group coverage through an employer-sponsored plan is often the best way to get dental insurance, it still doesn’t mean the plan is right for you, so always check the specifics before joining one.
Individual policies are more expensive than group policies, whether you are buying a single policy or one for your entire family, and there are definitely drawbacks to this coverage. They come with more-limited benefits and insured parties usually have to wait before major procedures are approved. If you plan to sign up for a plan just in time because you need implants or new dentures, it won’t fly. Insurers are well aware of that strategy and usually establish a waiting period before you can start using certain benefits, lasting anywhere from a few months to a year, depending on the procedure. However, there are some plans without waiting periods, although they usually cost more.
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Before you make a decision, it’s best to comparison shop. Get price quotes and policy details from insurance company websites or talk to a knowledgeable insurance agent.
If you have a dentist you like, ask what insurance plans they accept. As mentioned above, indemnity insurance plans allow you to use the dentist of your choice, while PPO and HMO plans limit you to dentists in their networks. If you don’t mind using a new dentist, a PPO or HMO may suit your needs.
However, it is wise to be cautious. The new dentist you visit is likely to tell you that you need more unexpected work. A revealing account in Vox by Joseph Stromberg, the son of a dentist, describes how some in-network dentists may recommend unnecessary procedures to make up for lost revenue on preventive services for which dental insurers reimburse them at lower rates. Ask health professionals, neighbors and friends if they can recommend a local dentist they trust. Then check what insurance and discount plans that doctor accepts.
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It’s important to carefully review the policies you’re considering to budget for your dental expenses—anticipated and possible emergency expenses. For example, AARP Delta PPO Plan B covers exams, cleanings, X-rays, fillings, tooth extractions, root canals, gum cleanings and denture repairs from policy inception. However, you have to wait until your second year to receive benefits such as dental implants, crowns, gum-disease treatment, full dentures, and TMJ treatment (which includes problems with the temporomandibular joint that connects the jaw to the skull). Even then, the benefit is limited to 50% of the cost.
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If you or your child needs major dental work, know that you will have to pay a heavy share of the cost. Remember that with group and individual policies, benefits are limited and can vary significantly. Group plans may have waiting periods, and almost all plans pay only a portion of the cost for major work, so check the details. Your colleagues or friends may be insured by the same company but have a different benefit package than the one you are offering.
An important aspect of dental insurance is that coverage for preventive care like checkups, cleanings, and dental X-rays is great, although you may want to cover them less often than a dentist who’s eager to have them. Adults and children with dental benefits go to the dentist, receive restorative care, and experience greater overall health. Buying insurance can motivate you to seek preventive care and avoid more expensive and unpleasant procedures.
While buying individual dental insurance, be aware that major procedures may not be covered in the first year and even then the benefit is only half of what the dentist charges. You’ll need to set aside money in a Health Savings Account (HSA) or personal fund so you won’t fall short if you need a major job.
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