Dental insurance covers a portion of your dental needs by covering treatments and procedures like cleanings, root canals, x-rays, fluoride treatments, and implants. Before taking the insurance, you must ensure that it offers you and your family the most benefits. However, the number of insurance providers in the market makes the process of choosing lengthy and tedious.
One of the things you must do to ensure you get the best coverage is to determine the type of dental insurance you want. Different types have different benefits, coverages, out-of-pocket payment requirements, and dentist preferences.
Preferred Provider Organization (PPO) is the most common type that includes using dentists in the insurer's network. Since the dentists agree on a discounted fee, you pay more if you use a dentist out of the network.
The Health Maintenance Organization (HMO) is a good choice if you want more affordable insurance with a dentist network. It mostly focuses on preventive care, has lower premiums than PPO, and has a smaller dentist network. Sometimes, this insurance requires that you live within where it is offered.
One of the main benefits is that dentists might change their costs for different dental services, making them more flexible.
For more flexibility in choosing a dentist, a discount plan is appropriate. These plans allow you to choose a dentist offering discounts for different services and pay the dentist directly. These plans have lower premiums than HMOs and PPOs.
While they are not common, managed free-for-service dental plans offer the widest selection of dentists. Like PPOs, you have to pay coinsurance for every provided service, and the insurer pays the rest.
Before choosing your dental insurance company, look at their dentist network and determine their dentists' qualifications, experience, reputation, and reviews. You should also look at their equipment and clinics' condition.
After understanding what goes into different insurance covers, determine what they cover and whether they cover your and your family's unique dental needs. The first thing to determine is the procedures it covers.
Most insurance plans cover preventive care, tooth extractions, fillings, root canals, dental crowns, dental bridges, and orthodontia. While you might also get coverage for implants, gum disease treatment, TMJ treatment, and complete dentures, most plans require waiting for one or two years. You must also ask about cosmetic procedures because most plans don't cover them.
You should also look at the waiting period. This is the period between getting the coverage and when you start receiving the benefits. The annual maximum limit is another factor that helps determine a good plan. That is the total amount the insurance plan will pay for your benefit period.
Cost is the next most important thing to help you choose the best plan. Premiums are the most important cost factor where you must determine whether you want monthly or annual premiums.
You also need to consider deductibles, the amount you pay out-of-pocket for each procedure. Usually, the higher your premiums, the lower your deductibles.
Another additional cost is co-payment. You must pay this fixed amount every time you receive treatment or get a prescription. It serves to split the cost between you and your insurer, but not all plans have them.
Dental insurance plans also include an annual cap. This is the limit that the plan covers for your procedures annually. Once you go above that cap, you pay for your dental procedures for the remainder of the year.