Dental insurance is one of those things that's easy to put off until you need it. But when you need it, having dental insurance can be a lifesaver. According to the ADA, over 130 million Americans don't have dental insurance, so many Americans forego necessary dental care. If you're one of the millions of Americans without dental insurance or thinking about switching dental plans, here are seven things you need to know.
When it comes to dental plans, there are three basic types: HMOs, PPOs, and indemnity plans. HMOs tend to be the most affordable but also have the most restrictions. PPOs are more expensive but offer more flexibility in terms of choosing your dentist. Indemnity plans are the most expensive but provide the most freedom in choosing your dentist.
Most dental plans have a waiting period before they cover significant procedures. Waiting periods can range from six months to two years, depending on your plan. This means that if you need a major procedure done right away, you may have to pay for it out of pocket or wait until your waiting period is over before your plan will start covering it.
Dental plans also require you to pay a deductible before they start covering services. Depending on your plan, deductibles can range from $50 to $1,000. This means you'll have to pay for any services up to your deductible amount out of pocket before your plan starts covering them.
Dental HMOs usually require you to choose a primary care dentist from their network. This means you'll need to get your routine care, such as cleanings and X-rays, from this dentist. If you need special care, such as orthodontics or oral surgery, you'll need to get a referral from your primary care dentist before seeing a specialist.
Dental PPOs usually allow you to see any dentist within their network but may require you to pay more if you see an out-of-network dentist. This means that while you have more flexibility in choosing your dentist with a PPO, you may pay more out of pocket if you see a dentist who's not in their network.
There are two types of dental discount plans: membership-based and provider-sponsored. Membership-based plans usually require an annual fee and give members access to discounted rates at participating providers. Provider-sponsored plans usually only offer discounts at one particular provider's office. Both discount plans typically do not cover preventive care such as cleanings and X-rays.
When it comes to choosing a dental plan, there's a lot to consider—from the type of plan to the annual maximum benefit and everything in between. But by taking the time to understand how dental insurance works, you can be sure that you're getting the best coverage for your needs.