Dental Health Insurance

Choose Your Dental Insurance Carefully for Best Results

Buying dental insurance is different than buying a regular health insurance plan. The terms and the focus are often different, and some of the things that you might think are covered may not be covered at all. Dental insurance plans vary considerably between companies, so you will need to look carefully at the details if you are getting individual dental insurance.


The Focus Is Different

Instead of just meeting needs as they occur, dental plans aim for prevention. Many of them will offer 100 percent coverage for preventive care, which will usually cover such things as x-rays, dental cleanings, and check-ups. The higher percentage for preventive care aims to prevent costly procedures before they occur, and will pay a smaller percentage for the actual treatment of larger problems.


Maximum Coverage

Nearly all dental plans will have a maximum amount of payments that they will make each year. The caps are usually set at either $1,000 or $1,500 per year. Many of the more expensive procedures may cost more than this, so it is likely that you will still be paying considerable costs out of pocket. In addition, there may also be a deductible amount.

Partial Coverage

Many dental treatments are only covered by a percentage of the cost. Basic procedures will often pay around 80 percent of the cost, and this may include fillings – amalgam only, reattaching existing crowns, and dental extractions.


Major dental work is usually covered by more dental insurance plans at a rate of 50 percent. This would include treatments such as bridges, crowns, root canals, and dental implants. This means that if you have a root canal and a crown, the total cost could be around $2,000, or more. If the insurance pays 50 percent, you will pay $1,000 for it, plus any co-pays.

Depending on your dental plan, this could end up being the only service the dental insurance plan will pay for because you reached the maximum amount. Of course, they would still pay for preventive dental services.


Pre-existing Conditions

Most dental insurance companies have clauses in their contracts that will prevent you from benefiting by getting dental coverage just when you need to have some major work done on your teeth. In many cases, after you buy a dental insurance policy, you may still need to wait at least 30 days before you can even get any preventive care. Getting fillings and other restorative services may require a  waiting period of three months or more,  and any major treatments may require a wait of at least six months or more.


When you go to buy dental insurance, it is quite likely that you will need to sign up for a minimum of one year. Some of the more expensive treatments may require waiting a year or more. These treatments often include orthodontics (if covered at all), bridges, and dentures.


Group Dental Insurance

There are also some things you need to know about getting a dental insurance plan through your employer’s group plan. While it may only cost you a few dollars a month for it, it may not be worth it if it is for your whole family. Many times these plans only have a maximum cap of about $1,000 for the entire family. As seen earlier, this cap may not cover much if one or more of your family members need some major dental work.


Dental Insurance Not Required

Under the Affordable Care Act, health plans offered in the Marketplace may also offer dental health insurance. If it is offered as part of the plan, it is included in the cost of the premiums. If it is not part of the plan, you are free to buy the one offered by the health insurance company you choose, or you can buy a separate dental plan.


Dental Insurance for Kids

If you have people in your home under the age of 18, the Affordable Care Act requires that the insurer make dental insurance available for them – but you do not have to buy it. Adults do not have to have it, either.


Buying Dental Insurance

Before you go and buy any dental insurance, if you have a dentist you like already, check to see what insurance plans they accept and choose one. Look for one that provides the best benefits for you and your family.


Dental Savings Plans

This alternative to dental insurance offers club members a discount of anywhere between 10 to 60 percent of the usual costs. There are many dentists that honor dental savings plans, and some of them are offered by major insurance companies. There are no annual caps, limits, or waiting periods.


When you need dental care and have a dental health insurance plan, or want help in choosing one, Dr. Kumar T. Vadivel, DDS, FDS RCS, MS, a Board-certified Periodontist, can help you. He has offices in the Carrollton, TX and Grapevine, TX areas. You can contact his office today at (817) 756-8578.


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