Finding the Right Dental Insurance Plan

With the variety of dental insurance plans and dental savings plans available on the market today, it can be difficult to figure out which plan is the right one for you.

Choosing the right dental policy begins by familiarizing yourself with what are the different types of dental insurance and savings plans that are available in your area. Once you have an idea of what sorts of plans are available and how each one works, you can start to prioritize your own needs for the dental program you are looking for. You will want to start thinking about what sort of dental work you expect you will need in addition to any regular preventative care appointments that you know you will need in the upcoming year. This list will be very important when trying to compare the benefits of each dental plan because the pros and cons of each can depend significantly on the specific dental work you want done. It is also a good idea to try to estimate your budget for dental work, how much you can dedicate to a premium and other out-of-pocket costs before choosing a plan so that you can tell right away which programs may be out of your price range. Learn more about how to find the right dental insurance plan for your needs by reviewing the information below.

Dental Insurance and Savings Program Basics

There are a few different types of dental plans that you are most likely to come across when shopping for your next policy. You will have both dental discount plans and dental insurance plans to choose from, the technical difference being that dental discount plans are not insurance because they do not pay dentists for you and are also not regulated by the same legal rules. Dentals savings plans offer program enrollees access to a discounted schedule of fees for an established network of doctors for a low annual premium with no waiting period and no annual maximum coverage limit. With savings as high as 60 percent for some dental procedures, dental discount programs can be a great choice for many people.

Dental insurance plans are generally either indemnity plans or managed healthcare plans. Indemnity dental insurance allows program enrollees to see basically any dentist they want for a predetermined price set by the insurance provider. Some indemnity dental plans use a direct reimbursement strategy, refunding a set percentage of all costs of eligible dental work to the plan participant, while other use a schedule of allowances plan that pays out a set amount for each dental procedure as listed on a schedule of allowances, regardless of how much the dentist chosen by the program enrollee charged for the service. Managed dental insurance plans, like dental health maintenance organizations (DHMOs) and dental preferred provider organizations (DPPOs), provide program participants with an established network of dentists that they can visit for free or at a percentage of the cost. Enrollees in managed dental programs choose a primary care dentist in their network to receive full program benefits. Some programs allow enrollees to visit out-of-network dentists with less coverage than in-network dentists while other managed dental care programs provide no coverage for out-of-network visits.

Questions to Keep in Mind When Choosing the Right Dental Plan for Your Needs

The best dental plan for you will depend significantly on the types of dental policies available to you and your expected needs for the near future. Understanding how dental plans work can also help you figure out which plan will suit your dental needs. To help you figure out which dental insurance program might be best for you, ask yourself a few of the following questions:

  • How much freedom to you want to choose your dentist?

Like choosing a medical insurance plan, finding the dental insurance plan that is right for you depends on how much freedom you want to choose your dentist. Managed dental insurance plans generally provide the lease amount of flexibility when it comes to dentist choice, with rigid boundaries concerning in-network and out-of-network providers. Discount dental savings plans can sometimes be regional or simply have few contacts in certain areas, so checking out their list of providers in your local area is important to understanding if they will meet your needs. Indemnity dental insurance policies may be the best choice for people who highly prioritize the freedom to choose their dentist because these plans apply blanket policies for all dentists, they may not be the best choice for someone who needs more dental work than a maximum coverage allowance will permit.

  • Does the dental insurance plan have a maximum coverage limit?

Both indemnity dental insurance plans and managed dental insurance plans generally have a maximum coverage limit. This means that you can only be covered for that amount for the entire annual period. Many dental insurance plans have maximum coverage limits that are between $750 and $2,000, which often do not cover major dental procedures or multiple smaller ones. Some dental insurance plans have maximum coverage limits that are not much higher than their annual premiums, making them beneficial only for policyholders who take full advantage of any free preventative care dental services provided by the program or the combined benefits of adding family members onto the plan. A great benefits of dental savings plans is that they almost never have maximum coverage limits.

  • Are there other limits to dental work coverage?

In addition to a maximum coverage limit, some dental plans limit how much dental work can be done on any given tooth or area. Along the same lines, some dental plans provide a cap on how many procedures of a certain type or within a certain period of time a single enrollee can get coverage for. Again, these limitations rarely apply to dental savings plans.

  • Does the dental plan utilize service categories to divide types of dental work? Are they reasonable?

Many dental insurance plans and savings plans divide dental work into different categories along the lines of preventative, minor and minor services performed. While this may seem straightforward, various insurance providers and savings plan administrators categorize the same procedures significantly differently, resulting in patient prices that can range widely from program to program. This is why it is so important for you to look for the program savings or reimbursement of the specific dental work you think you might need done in the dental plan you are considering to understand exactly what you could be expected to pay if needed.

  • Does the plan include free or almost free preventative care dental services?

A great perk of many dental insurance plans is free or almost free preventative care services like checkups, cleanings and sealant applications. If the plan offers no free dental services, preventative care services should be the least expensive or most highly discounted dental services available in the program. If no dental plan is willing to offer you free preventative dental care, you may be able to find a dentist that offers free preventative services for choosing her as your primary dentist for your other needs.

  • Can family members be added to the dental plan?

If you have dependents on your healthcare insurance plan, odds are you are shopping for a dental insurance plan that allows you to add your family members as well. Many dental insurance plans and savings plans allow you to add family members for low rates, according to plan conditions. Family members should be able to gain the same access as the primary policyholder to associated benefits and free dental services for a reasonable add-on price.

  • Is there a waiting period before dental work can begin?

Many dental insurance plans require new enrollees to wait between six months and a year before many dental insurance benefits can be used. While preventative dental care appointments may still be covered by the plan, any significant dental work must wait until the period is over. Dental insurance providers do this to dissuade people from signing up for dental insurance for an immediate need and than trying to cancel coverage immediately thereafter. Discount dental insurance programs almost never have waiting periods for enrollees.

  • What are the total out-of-pocket costs for the dental plan?

While you will no doubt look at the monthly or annual premium price tag of whatever dental plan you are considering, don’t forget to take into account the so-called hidden fees as well. Dental insurance plans often leave program enrollees to cover a combination of deductibles, copayments and co-insurance fees in addition to whatever percentage of covered costs is left to the enrollee. These fees are sometimes known upfront, like with most managed dental care plans, but can sometimes be a surprise revealed when you receive a lower reimbursement check than you expected. While discount dental insurance plans may be somewhat more straightforward when it comes to pricing, offering a schedule of discounts for dental services no matter what dentist you visit, many require program activation fees and other service charges that are not initially obvious.

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