Is your dental insurance good enough?

A dental insurance plan is much like a typical health insurance plan but it protects everything pertaining to a patient’s dental needs. Dental insurance is customarily separate from full medical coverage, but participants are advised to inquire their medical insurance provider as to whether dental is included. Understanding how dental insurance works is pertinent to knowing whether your dental insurance is indeed good enough.

Dental insurance can cover bills that are either related to maintenance of teeth and gums or the repair of a major problem. It is especially serious during issues such as a root canal, wisdom tooth removal or orthodontia that dental insurance is useful and effective in managing costs. There are many different levels of coverage which entitle a patient to more services, but regardless of what a patient chooses, a monthly premium is paid by the patient to the dental insurance company. Then, instead of paying a hygienist, dentist or oral surgeon, patients with dental insurance give a small co-pay. Other benefits include no co-pay for annual cleanings, x-rays and other services depending upon the insurance company and level of coverage provided.

Dental plans can offer a wide range of benefits depending upon the level of care a patient requires. Most insurers create plans that accommodate individuals, families and businesses so that health care is tailored to the particular needs. The plans are arranged comparably to medical insurance and are generally as follows:

PPO Plan

This plan allows the patient to choose from a “network” or large number of dentists in his/her area. The plan is based upon a dentist agreeing to a contracted rate within the PPO system and the patient then paying 20% of the dentist’s PPO rate. Some services are covered at different percentages which the insurance company will state ahead of time. Also, many plans have a deductible and an annual maximum coverage limit. This plan’s benefits lie in that the patient has the lowest out of pocket expense at the time of visit and may see the dentist of choice.

HMO Plan

This is a plan that requires the patient to select one dentist for the entire coverage period. Instead of paying a co-insurance amount, the plan is “pre-paid”. Each procedure has an associated cost and the patient pays this amount when the services are rendered. Certain preventative and diagnostic procedures are fully covered without cost to the patient. With an HMO plan, there is no monthly premium, however, the patient must choose only one dentist and the out of pocket expenses are higher. This is still a very affordable option for many patients.

Traditional Plan

Very similar to the PPO plan with a monthly premium, the plan allows full choice of dentist with no network boundaries. Instead of a fixed co-pay, the percentage of coverage will change dependent upon the procedure with preventative care costing less.

Regardless of whether you have few dental needs or may be next in line for braces, dental insurance is accidental coverage just like any other type of health insurance. It is important to evaluate your personal needs and financial ability just as much as the advice of your current or future dentist. Speaking to someone from a dental insurance carrier about your different options will also help you to decide whether you have the right insurance for your health requirements.