Home HEALTH & FITNESS What type of dental plan should I get?

What type of dental plan should I get?

by SML Kumar

Choosing a dental plan is no easy task. You will find yourself facing an overwhelming number of dental plan options to choose from. Let us make the process easier for you and help you find the best dental plan for you.

  • What is included in a dental plan?

Dental plans vary according to the types of services they offer. Most dental plans include coverage for:

  • Routine and preventive care: Routine and preventive care involve checkups, fillings, cleanings, diagnostic x-rays, fluoride applications, gum care, root canals, and some types of oral surgery.
  • Emergency care:Emergency care involves broken or cracked teeth, immediate tooth extractions, and treatment following an accident involving the jaw and the teeth.
  • Complex care:Complex care includes orthodontic (braces) and prosthodontics (crowns, bridges, veneers) treatment. Most dental insurance plans cover only up to half of the cost of these procedures.

 

  • What are my options when it comes to dental insurance plans?

Dental Indemnity Plans

Dental indemnity plans, or freedom-of-choice dental plans, are the most flexible as they do not come with provider networks. People with dental indemnity plans have the liberty to go to any dentist,and the plan reimburses on its own fee schedule.

Dental indemnity plans do not cover the full costs, however. The member is required to pay the amount that is not covered by the insurance plan. Unfortunately, some indemnity plans have very low-cost coverage.

Dental indemnity plans tend to have the highest premiums and co-pays (a set fee that you are required to payevery time you visit a dentist) for comparable coverage since they provide you with the most flexibilityto choose any dentist you want.

Managed Care Plans

Managed care dental plans offer a pre-approved list of dentists in a network of providers who have agreed to discount their fees. These plans can be dental PPOs or dental HMOs. The rules are somewhat similar to medical PPOs and HMOs.

HMOs are the least expensive kind of dental coverage. In this plan, you get all your dental care from the dentists in your plan’s network. If you opt for treatment from someone out of the network, you will have to pay the full cost of treatment.

PPOs are the most employer-provided dental insurance plan. Their premium costs are slightly higher as compared to HMOs. PPOs also come with a preferred network of providers. Their network, however, is usually bigger than an HMO network. Unlike HMOs, PPOs offer some coverage even if you seek care from someone outside the network.

Dental Discount Plans

Dental discount plans are not exactly considered insurance as these plans provide the customer with a discount for dentists that have agreed to be part of the plan’s network. The plan itself, however, does not pay anything towards the cost of your care. In dental discount plans, you pay for your own treatment at just a discounted rate.

Dental discount plans are much cheaper than dental insurance. Additionally, unlike dental insurance plans, they do not come with waiting periods before you start to avail the discounts.

  • Why do I need dental insurance?

Dental care does not come cheap, which is why having secure dental insurance is essential. Whether you get it from your employer or purchase one yourself, it is essential to choose an insurance plan that covers dental care for you and your family.

As per the American Dental Association, the high cost of dental care is one of the primary reasons why so many people avoid it. Dental care is more expensive than all other healthcare facilities, including medical care,mental health care,eye care, and prescriptions.

On the plus side, however, unlike medical bills, dental bills are easier to anticipate. Routine dental needs such as checkups, diagnostic x-rays, cleanings, and morecan be predicted. Some dental emergencies may come up, such as a broken tooth, a displaced crown, or a gum infection. However, these dental emergencies are much easier to deal with as opposed to a medical emergency such as a heart attack, as they are more manageable in terms of costs.

Another reason to consider getting dental insurance is assessing the needs of family members that may require specialized dental care such as braces, dentures, bridges, implants, crowns, etc. Since these specialty care treatments are not categorized under essential dental care, most insurance plans usually only cover a portion of the cost. The patient must pay for the rest of the bill. There are some dental plans; however, that covers the major part of routine care expenses such as fillings, cleanings, exams, and x-rays.

  • How do I choose a dental insurance plan?

If you are getting dental insurance from your employer, you may be restricted to a single plan option. Bigger companies may offer you a choice of plans to choose from. If you are buying your own insurance, you can select any plan available in your area.

How do you make a choice? The dentists in your list of providers and the amount of direct out-of-pocket spending that you can afford are the two main factors that you must consider.

Some plans will allow you to seek treatment from any dentist, whereas others will restrict you to limited options in an assigned network. While the liberty to consult any dentist may seem like a good idea, it is not the best choice if it comes with a smaller benefit limit or lower reimbursement rates.

  • What are the costs of dental insurance plans?

You can assess the affordability of an insurance plan depending on its premium payments and the portion of dental costs that you have to pay out-of-pocket (either because the plan does not cover them or only covers a part of the total cost).

A low-premium dental plan may cost you less in terms of initial investment, but you may not end up with the bargain you had hoped for, as you would be paying much more out-of-pocket.

Conversely, it is also not the best idea to pay high premiums for a premium dental plan when you only need to visit the dentist for biannual cleanings and routine checkups.

Points to consider:

  • HMOs have more predictable costs. Therefore, if you are not one for surprise expenses, this is more suited for you.
  • PPOs have a bigger pool of dentists to choose from, but the costs are slightly higher and less predictable. If you prioritize the availability of choices, this plan is the better pick for you.
  • Dental indemnity plans offer the most freedom when it comes to choosing a dentist. If you have an old dentist that you are comfortable with but is not in any PPO or HMO network, a dental indemnity plan may be the best one for you, despite the higher premium cost and co-pays.

Before making a selection, it is best to visit your dentist for an exam, including diagnostic x-rays. Allow your dentist to assess your overall dental health and any potential issues that may arise in the future. This will help you decide what insurance plan is best suited for you and your individual dental needs and budget.

 

 

 

 

 

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