Sitting in the dentist’s chair has been a terrifying experience for generations. Nowadays, an even more terrifying experience is getting handed the bill. Having dental insurance will enable you to take care of your oral health without worrying so much about the cost.
Dental care is essential when you need to treat that toothache or cavity, and it is also useful when you need to schedule regular checkups and cleanings. Whether you want to purchase dental insurance for your family or for your employees, this is what you need to know about group dental insurance plans.
What Does the Dental Plan Include?
In order to know which plan best suits your needs, you have to know what dental plans typically cover. Dental insurance plans vary in the services they offer, which also affects the cost of the plans. The main components of dental plans are:
- Diagnostic and Preventive Care: Some plans cover only basic services like cleanings, checkups, and x-rays.
- Basic Restorative Care: This level includes fillings, root canals, extractions, gum care, and other simple restorative services.
- Major Restorative Care: This category includes crowns, dentures, bridges, and other major dental services.
- Orthodontic Services: These plans usually cover half the cost of braces and other corrective services.
Types of Dental Plans
Dental plans are quite similar to health insurance plans in some respects; however, the premiums for dental plans are far lower. The catch is that health insurance plans cover a big chunk of the expenses while dental plans typically follow a 100-80-50 coverage scheme (i.e., 100% of diagnostic and preventive care, 80% of basic restorative care, and 50% of major restorative care). When choosing a dental plan, you will encounter the following options.
Preferred Provider Organization (PPO): This is the most common type of dental plan, in which the dentists that have an agreement with your insurer make up your network. These dentists will accept your plan; however, if you want to go to a dentist out of the network, your out-of-pocket costs will be higher.
Health Maintenance Organization (HMO): This type is the least expensive of all the dental plan options. Like a PPO, it features a network of dentists that accept a particular plan but typically with even lower out-of-pocket costs.. However, if you see a dentist out of the network, you will pay the full cost of any services you receive.
Indemnity Dental Plans: This is the best plan for people who don’t want to be restricted to a network of dentists. On the other hand, it is the most expensive dental plan type and it is not very common. Insurers put a maximum on the amount of money they are willing to pay for various services. For example, if your dentist charges $5,000 for braces and Invisalign, and the insurer only covers $3,500, then you’ll pay the difference yourself. Most of the insurance companies that offer indemnity plans require that you pay for the whole cost then file a claim for reimbursement afterward.
Discount or Referral Dental Plan: This type is not a true insurance plan. It refers to a network of dentists that will offer a discount on their services when you visit a provider who is part of the network. You have to pay the full bill but receive a discount from the dentists themselves. A discount plan is less expensive than dental insurance plans and doesn’t have waiting periods.
Dental Plans Waiting Periods
Insurance companies know that people tend to think about a dental insurance plan when they need it immediately. That’s why they have waiting periods for certain services. Going for preventive care and other simple services are covered immediately or within 30 days after you purchase the policy. After 3 months, you can visit your dentist for restorative services, while for major restorative services you have to wait 6 months. Your plan may not cover some services until a year has passed, which is a long time to wait if you need to cover the cost of a root canal.
You need to plan ahead, before you actually need a dentist, and maintain good oral hygiene to avoid any big surprises. There are many dental plans on the market, so you should think about what exactly you need from your plan. If you want to see a specific dentist then you need to know which plans he accepts. The costs of premiums, co-pays, and deductibles are also essential to consider before you make up your mind. Do your research and keep these tips in mind, so you can find the plan that’s right for you.