Only the very best will do for you and your loved ones’ teeth. But finding the dental insurance plan that ranks in the “Top Ten” isn’t easy.
The plan that works perfectly for one person or family may not offer the right combination of cost and coverage for another. Your Top Ten dental insurance plan is the one that meets your dental care needs, budget and preferences.
That said, there are specific things to look for that would make a particular dental plan a Top Ten for you. Here are some things to know when you’re researching dental insurance plans
Dental Insurance Cost and Coverage
The typical cost of an individual dental insurance policy is around $350 a year. For a family, the cost is around $550, annually. The price you pay for your dental insurance is called the “premium.”
Most dental insurance policies cover 100% of the cost of preventative care such as cleanings, checkups and x-rays, 80% of basic treatments such as fillings, and 50% of the more complex procedures such as root canals and crowns.
So let’s crunch some numbers: two checkups and cleanings and a set of X-rays will cost, on average, from $375-$400, according to the American Dental Association. So your dental insurance policy enables you to pre-pay for your essential preventive care, plus you know that if you need a couple of fillings, or chip a tooth, you’re also covered.
Dental Insurance Maximums – Annual Caps
But wait … what about the costly treatments such as root canals and crowns? The amount of coverage you can expect for these sorts of procedures depends on the annual maximum coverage provided by your plan, also known as the “annual cap.”
Dental insurance policies generally limit coverage to $1000 -$1,500 a year. When your dental costs for most procedures go over that limit, you then have to pay for your own dental care out of pocket for the rest of the year.
The average cost for a crown is $750-$2000 per tooth, and the cost of a root canal is $750-$1,000 per tooth. Obviously you can exhaust your annual dental coverage of $1000-$1500 fairly quickly. If you know you’ll need major work at some point in the future, you may want to look for a policy with a high cap. You’ll pay higher premiums, but you may not max out your coverage in one visit.
Also, you can talk to your dentist about scheduling treatments in line with your dental coverage. For example, if your plan provides a year’s coverage starting in January and you need a root canal and crown that will cost about $3,000 you might be able to get $1500 worth of care in December, and finish your treatment in January. That’s assuming, of course, that you have your full annual maximum unused by the end of the year, and are willing to exhaust your coverage at the beginning of the next year.
Dental Insurance Deductibles
Your plan’s deducible is the amount that you will have to pay out of pocket for dental services before your insurance will begin to cover a portion of your dental care costs.
The typical deductible is $50 for an individual annually, and $150 for a family. Some plans exclude preventive care from the deductible, which means these procedures are fully covered even if you haven’t met your deductible. So make sure to get that preventative care – your checkups, cleanings and x-rays. Being proactive about dental care is very important for your oral and overall health, and saves you money in the long run.
Dental Insurance Waiting Periods
Another thing to consider if you’re delaying seeing your dentist is that dental insurance may not provide immediate coverage for pre-existing conditions. With a new-to-you plan, you’ll usually have to wait six months for basic restorative services or a year for major restorative services.
Dental insurance often will not pay to restore teeth that were decayed, broken or missing before you purchased the policy, and may not play to complete any dental care treatment that was already underway prior to the policy going into effect.
There are some exceptions to the waiting period imposed for major procedures; a few insurers will waive their wait period if you can provide proof of continuous dental insurance coverage within 30-90 days prior to your purchase of their policy. This is a feature to look for if you want to switch insurance providers, or if you’ve lost your employer-provided coverage.
If braces, dentures or bridges are something you or a loved one does or will likely soon need, make sure the plan you choose covers these particular procedures. If you’re an adult who is considering orthodontia, make sure the policy covers orthodontic services for all ages, not just for children.
Also look at the waiting period for getting the treatments you know you’ll need, and see if you can realistically wait that long to get care.
In or out? Dental Insurance Networks
A dental insurance plan’s network is comprised of all of the dentists that have agreed to accept the discounted rates negotiated by the plan’s provider.
It’s important to note that a dentist may accept an insurance plan, but may not honor the negotiated rates – so you typically get the greatest savings from your plan’s in-network providers. Some plans do not cover care provided from a dentist outside their network, so check with your provider before you head to the dentist’s office.
If you already have a dentist that you want to continue to work with, ask him or her what insurance plans they accept and which one they recommend for you.
Top Ten Dental Insurance Alternatives
Dental savings plans, are an affordable alternative to traditional insurance, offering members discounts of 10%-60% on their dental care.
Why choose a dental savings plan instead of dental insurance? Dental savings plans activate quickly – usually within 72 hours of purchase – have no annual caps, no waiting period is applied for accessing care, and no restrictions on obtaining care for preexisting conditions. You simply use your plan to save whenever you go to the dentist.
Carefully consider your dental options – dental insurance, a dental savings plan or consider self-insurance (banking the amount you’d pay for insurance into your own health savings account). Also, you might want to ask your dentist about dental savings plans, or if the practice offers their own in-house dental financing plan.
You can also check into health care credit plans, but make sure you read the details carefully and can meet the payment schedule. If you can’t make payments when you’re expected to do so, the interest and penalties can mount up quickly.
If you don’t have hours to spend researching your options, call :DentalPlans at us 1-800-238-5163. A member of the :DP AtYourService Customer Care team will be happy to help you quickly determine what plan is right for you.