Dental insurance companies spend a lot of ad revenue promoting their coverage to millions of Americans each year. For the consumer, though, picking the valuable information from the barrage of ad speak is not easy.
But pick a plan you must. If you don’t choose correctly, you might end up having to pay out of pocket. If you are looking to sign-up for dental insurance for the first time or are thinking about changing your existing plan for a better one, there are a few things you need to know.
Why You Should Shop Around For Dental Coverage
Dental care is moving towards more sophisticated procedures, from less painful treatments to fully automated dental insurance verification systems. Dentist practices are keeping operations efficient, lean and profitable. So why shouldn’t patients become more mindful as well?
Dental insurance is not as complicated as medical insurance; that is why many patients fall short of getting the best plan for their needs. Research is an exhausting and never ending endeavor, so we did it for you and condensed our findings in this easy-to-follow guide.
These are seemingly simple questions that a quick online search can also answer. But it is essential that you ask your prospective provider about these topics prior to signing up. Your teeth and your pocket will be the better for it.
Can You Choose Your Dentist?
Many dental insurance providers have a list of on-network dentists that you can choose from. If your dentist is not on the network and you still want to visit their practice, you will have to pay a lot more for the same services, so much that the cost is not worth it.
How Much Are You Covered For?
Most plans have annual coverage up to $2000. This means that special procedures such as dental implants, which cost up to $3000, will not be covered. Basic treatments such as cleanings, x-rays and routine exams are covered immediately.
Are you covered for Emergencies?
Ask your dental insurance provider what provisions they have for emergencies, especially if your plan includes children. Dental coverage has provisions for emergencies so that you do not face unprecedented costs during the holidays or if you face an emergency while out of town.
Are You Covered for Specialist Care?
Sometimes you go to the dentist for a routine exam and discover that your mild tooth irritation is a more severe issue. Dentists typically refer you to a specialist in these circumstances. Although this is not a regular occurrence, it is better to have options beforehand.
Can You Use Your Tax Credits for Insurance?
You can use your tax credits towards pediatric dental premiums for your children but only in the circumstance that your health insurance does not have pediatric dental coverage. If it does, you can use the leftover tax credits to purchase an additional plan.
Are You Covered for Pre-existing Conditions?
The real determining factor for coverage of pre-existing conditions is the period of exclusion which describes how long you have had the condition. Most dental coverage has provisions for only minor pre-existing conditions; for most, it is, unfortunately, out-of-pocket payments.
How Soon Can You Start Using Your Dental Coverage?
Before you book your next appointment with the dentist’s office, make sure you know if your routine exams and cleanings are covered immediately. Most plans cover routine procedures, but there are wait times of up to 12 months for any restorative work such as fillings.
So What Is Your Best Option
After doing all this research, why not do just a little bit more. After all, your time, money, and teeth all are worth it. When you sign-up for a dental care plan, don’t just go for the company that covers treatment from your dentist, but also investigate how you can get your money’s worth.
We recommend that you go for a customizable plan that lets you choose what you want to be covered. That way, you won't be paying for unused benefits, nor will you miss out on necessary procedures. Stand-alone policies are the happy medium between these two scenarios.
It might seem a time-consuming task, but once you have decided what the oral healthcare needs of you and your family are, you can customize a plan and then never have to worry about payouts and limits again. Your next appointment will be breezy and fully covered.
Even though the world of dental insurance is not as labyrinthian as medical insurance, it still warrants due diligence on your part. Primary factors to consider are the coverage for children, pre-existing conditions, and specialist care.
If you go for lower-cost plans, you may still upset your budget with a lower maximum payout limit. It is better to pay a little more each month if you anticipate yourself using dental care services with a certain level of regularity.
About the Author
Nikki Gordon is dental billing and marketing specialist at DentalRevu. Having served for years in the dental billing industry, she’s got command over all the significant insights and loves to share them with newbies in the field. With an eye for practical procedures, her articles are a treat to those curious about learning the dental billing’s technical side.