Choosing the best dental plan can be a challenge. It would be easy if there was one best dental insurance plan offering the perfect combination of cost and coverage. Sadly, such a thing does not exist. The best insurance plan is the one that meets your dental care needs, budget and preferences.
That said, here are some tips that will help you find your best dental insurance plan.
Dental Insurance Basics
Most dental insurance policies are “100/80/50” plans. That means the plan covers 100% of the cost 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.
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.” The term “premium,” in the insurance world, comes instead from the Latin words prae ‘before’ and emere ‘buy, take.’ This refers to the practice of paying for insurance now to potentially gain a reward in the future.
If you pay out of pocket for two checkups and cleanings and a set of X-rays, your cost, on average, will be around $375-$400, according to the American Dental Association. So, with a dental insurance policy, you’re basically pre-paying for your essential preventive care, with a little assurance built in that if you need a couple of fillings, or chip a tooth, you’re also covered.
Dental Insurance Deductibles and Maximums
Before you buy dental insurance, check the amount of the plan’s deductible. The deducible is an amount that you will 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 exclude preventive care from the deductible, which means these procedures are covered even if you haven’t met your deductible.
You should also check 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 for the rest of the year.
Given that the average cost for a crown is $750-1200, and the cost of a single implant starts at $1500, you can exhaust your annual dental allowance 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 probably won’t max out your coverage in one visit.
Additionally, check to see whether a maximum amount is an annual maximum or a lifetime maximum. You’ll likely see lifetime maximums only for lengthy services such as orthodontia (braces) or long-term issues such as dentures (which typically need to be adjusted, repaired or replaced over time).
Waiting periods and networks
Dental insurance typically doesn’t 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.
There are some exceptions to the waiting period imposed for major procedures; a few insurers – notably Cigna- waive the wait policy with proof of continuous coverage within a month or so prior to your purchase of their policy. The assumption being that if you had dental insurance previously, your teeth and gums are probably reasonably healthy.
If braces, dentures or bridges are something you or a loved one does or will need, make sure the plan you choose covers them. Look at the waiting period for getting the treatments you know you’ll need, and see if you can wait that long to get care. Also, if you know you’ll need pricey treatments, check to make sure that the amount of coverage offered by the plan makes sense to you – $1000 coverage specifically for braces may be just what you’re looking for, or may not meet your financial needs at all.
Also, be aware that 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.
Dental insurance networks
A dental insurance plan’s network includes 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 not honor the negotiated rates – 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.
Dental insurance alternatives
Dental savings plans, are an affordable alternative to traditional insurance, offering members discounts of 10%-60% on their dental care.
Why would you 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 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). With a little research, you’ll be able to choose the best dental plan for you.
To learn more about dental plans, call one of our :DP AtYourService Customer Care Representatives at 1-800-238-5163.