What is dental insurance, and how does it differ from medical insurance?
Dental insurance is generally designed to help with preventive care and part of the cost of other dental treatment. Unlike many medical insurance plans, dental plans commonly have an annual maximum, which is the most the plan will pay toward covered dental services during a benefit period, rather than a limit on what you may have to pay. Yes, they reversed it just to keep things interesting.
How much does dental insurance cost?
Cost varies by location, employer, plan type, deductible, network, coverage level, and other factors. Don't compare premiums alone. Also review the annual maximum, waiting periods, exclusions, coverage percentages, and your potential share of treatment costs.
What should you look for in dental insurance for major dental work?
If you're expecting major dental treatment, look at the annual maximum, coverage percentage for major procedures, deductible, waiting periods, network requirements, and exclusions. If you anticipate implants or orthodontics, check specifically whether those services are covered and whether separate maximums or limitations apply.
The least expensive plan can become very expensive when it excludes the treatment you actually need.
How does dental insurance cover braces, root canals, and dental implants?
Coverage varies significantly between plans. A root canal may fall under basic or major services depending on the policy, while orthodontics and dental implants may have separate limitations, waiting periods, exclusions, or lifetime maximums.
Always verify coverage for the specific procedure rather than assuming it's covered simply because you have dental insurance.
Is dental insurance worth it for routine dental care?
Dental insurance can help with the cost of routine care, particularly when preventive exams, cleanings, and X-rays are covered under your plan. When evaluating a policy, compare the yearly premium and other out-of-pocket costs with the benefits you're realistically likely to use.
Insurance can be helpful, but it should never be mistaken for an unlimited dental gift card.
What dental procedures may be covered by medical versus dental insurance?
Dental insurance may provide coverage for services such as exams, cleanings, fillings, crowns, root canals, and other dental treatment depending on the plan.
Medical insurance may sometimes provide coverage for certain procedures involving facial trauma, jaw surgery, biopsies, or treatment associated with a medical condition. Whether a service qualifies for medical or dental coverage depends on the diagnosis, procedure, and individual insurance policy.
What is supplemental dental insurance?
Supplemental dental coverage is additional coverage intended to help with certain costs that may not be fully covered by a primary policy. Whether having another plan is worthwhile depends on the treatment you expect to need and how the policies coordinate.
Premiums, exclusions, waiting periods, annual maximums, and coordination-of-benefits rules still need to be reviewed carefully.
How should seniors choose dental insurance?
Seniors may want to consider their current oral health, medications, gum health, dentures or implants, expected treatment, preferred dentist, and the plan's premiums, deductibles, network, coverage levels, and annual maximum.
Original Medicare generally doesn't cover most routine dental care, although certain dental services may be covered when they're directly connected to specific covered medical treatment. Some Medicare Advantage plans offer additional dental benefits, so it's important to review the details of the individual plan.
How can patients find affordable dental coverage?
Compare the options available to you, which may include employer-sponsored plans, individual dental policies, Medicare Advantage dental benefits when applicable, dental discount plans, or office membership programs.
Dental discount plans and membership programs aren't the same as dental insurance, so compare how each option works. Focus on the total cost, benefits, provider network, and limitations rather than simply choosing the lowest monthly price.
Can you have two dental insurance policies?
Yes, it's possible to have coverage under two dental insurance plans, but that doesn't guarantee that everything will be covered. When coordination of benefits applies, one policy is generally designated as primary and the other as secondary according to the plans' rules.
The secondary plan may contribute toward eligible remaining costs, but how much it pays depends on its coordination-of-benefits provisions and other limitations. Unfortunately, two plans do not create one magical super plan.
If you’re searching for quality dental care, we’re here to help. Call (551) 383-4441 or email [email protected] to schedule your visit. Our team is committed to keeping your smile healthy.