You’ve decided to buy a dental insurance plan. Or – lucky you – your employer is providing you with dental coverage. Understanding how dental insurance works will help to ensure you find the right plan at the right price. Here’s what you need to know to purchase and/or make the most of your dental insurance.
The first thing to know is that traditional dental insurance works a little bit differently than insurance for medical care. Many people rely on their health insurance primarily to help cover the high costs of major medical issues. In contrast, traditional dental insurance plans focus on helping you keep your teeth and gums healthy with affordable preventive care. This makes perfect sense – with regular checkups and cleanings, and good oral health practices at home, you’re much less likely to need costly treatments intended to rescue or replace decaying, weak teeth. It’s a win-win for you and your plan provider.
And yes, dental insurance also helps you fit the cost of expensive dental treatments into your budget. Most dental insurance plans are “100/80/50” plans. That means the plan covers 100% of the cost of preventative care such as cleanings, checkups and x-rays, 80% of basic treatments such as fillings, and 50% of more complex procedures such as root canals and crowns.
Saving Money On Dental Care with Insurance
Let’s crunch some numbers to figure out how you can save on dental care with dental insurance.
The typical cost of an individual dental insurance policy is around $350 a year. For a family, the annual cost is around $550. The cost for two checkups and professional cleanings plus a set of routine X-rays, paid out of pocket will be around $375-$400 on average, according to the American Dental Association.
So, as you can see, with a dental insurance policy, you are basically pre-paying for essential preventive care. So why not simply save that money in your own bank account? Because the better dental insurance plans offer benefits that go beyond preventative coverage. Remember, as noted above, you are also covered for 80% of the cost of essential basic dental services such as fillings, non-routine x-rays, and simple restorative work. You’re also covered at 50% of the cost for major services such as bridges, crowns, root canals and similar services.
Typically, you will save the most when your dentist is in your plan’s network, but (depending on the plan you choose) your coverage will probably also extend to out-of-network dentists and specialists. It is important to look at the details of a plan’s coverage to ensure that you are choosing the perfect plan for your own or your family’s needs. For example, if your children are likely to need orthodontia (or you’ve been considering getting adult braces for yourself) check to see if that benefit is included. Ditto if you want cosmetic services or dental implants – these services are not usually included in traditional dental plans, so spare yourself any possible disappointment by finding out exactly what your plan covers.
Premiums, Deductibles and Caps
It’s important to understand what premiums, deductibles, and caps are when you’re researching dental insurance plans.
The plan’s deductible is the amount that you have to pay out of pocket for dental services before your insurance will begin to cover their portion of the costs. The typical deductible is $50 for an individual annually, and $150 for a family. Some plans do not include preventive care in the deductible, which means that checkups, basic cleanings and a set of x-rays will be covered even if you haven’t met your deductible.
The annual maximum coverage provided by your plan, sometimes referred to as the plan’s “cap,” can be thought of as your annual dental care allowance. Traditional dental insurance policies generally limit coverage to $1000 -$1,500 a year per person covered by the policy. When your dental costs for most procedures go over that limit, you then have to pay for your own dental care for the rest of the year. Dental insurance providers offer plans with different caps so that you can choose the amount of coverage that is right for you.
Dental Savings Plans – An Alternative to Dental Insurance
Dental savings plans are an affordable alternative to dental insurance, providing plan members with discounts on most dental services. As an example, the majority of plans you’ll find on dentalplans.com offer savings of 10%-60% at the dentist.
Dental savings plan members pay a low annual membership fee for access to an extensive network of participating dentists and dental specialists that provide discounts on dental care at the time of service. Since they are not dental insurance, dental savings plans do not have co-payments, deductibles, paperwork hassles or annual spending limits.
Many of the plans on dentalplans.com offer additional “bonus” savings on health and wellness services such as vision and hearing care, discounts on prescription medications. Select plans offer savings on telemedicine, diagnostic tests, and fitness programs.
In addition, some dental savings plans offer discounts on some dental specialties that are rarely covered by dental insurance, including cosmetic dentistry services like veneers, teeth whitening, dental implants and more. Even if you have dental insurance, it may be worth joining a dental savings plan to get a discounted rate on specific services.