Dental Insurance-All you need to know

Nothing  in this world compares with the comfort that comes with having a good health. It doesn’t need to take much explanation to appreciate that for sure, health is wealth- for without proper wellness, it becomes impossible to chase any other dreams however much meaningful they may be. The best way to know that someone is for sure enjoying good health is in their smile and facial expression. With milk white, well aligned and firmly rooted teeth, smiling with the mouth open comes out very much easily. Without implying that those with coloured and damaged teeth deserve not to smile, they can always do it but with some level of uneasiness. 

Someone may be wondering where all this is heading but we need to agree that if there is one thing that investing in needs to be a priority then it’s health. Talking of good health, it includes psychological, physical, emotional…name it. A healthy person will show a unique sense of brilliance and positivity which is what we all long for even though only a few people mind to pay close attention to their health. 

We don’t intend to claim authority on matters of health for professionals that exist out there in their numbers. Instead, our focus is trained towards highlighting that aside from common diseases which people pay much attention to, dental hygiene and care is one area that misses out; not until a toothache starts. Actually, in some countries,  dentistry isn’t given much prominence, maybe because not so many tooth problems exist. But in other areas like Europe, so many predisposing conditions lead to a lot of dental health challenges. 

Anyone who has ever had a bad tooth, Bad Breath, Sensitive Teeth, Cracked or Broken Teeth, Receding Gums, Root Infection, Enamel Erosion or any other knows way too well how bad it can get. To just create a scene for you; a toothache can keep you awake the whole night because the stinging pain is unbearable. The nerves around the tooth are too sensitive which then means any slight problem brings about immense discomfort and pain. 

To undergo certain tooth care and treatments can be very expensive but because the pain that comes with them can’t allow for delays, people end up chucking out so much. It can be so devastating to need expensive  tooth care but lack the money. Even in cases where dental treatments are subsidized by the government, the balance can still be high. As a remedy, dental insurance is the real deal. We here unpack it all for those who really care about their dental health and wellnessYou might have come to this site Googling it, something we can thank the advice on sø for.

Your tooth care is part of your wellness-Take note

There is a direct link between good oral health and our overall well-being. Anyone who has ever experienced a toothache can understand just how important dental health can be. Imagine needing a crown repair or having a toothache during a work meeting away from home? This can be very frustrating to say the least especially if you thought your teeth were in perfect shape. Well, what does this mean? Teeth have a way of surprising us sometimes. Your dental care should always be a priority in your budget. So, ensure that it becomes your primary concern when it comes to good health and hygiene. One thing I know is that when a person experiences a toothache once, they wouldn’t wait again until they are in pain. 

Making oral care a regular thing will save you excruciating pain in the future. And what’s more? Most health insurance policies do not cover dental care. Even those that cover everything from preventative care to major surgeries. This is unfortunate but it is the way the world works sometimes. It gets worse if you are on a budget and need urgent dental care. 

Getting any form of dental work can be quite costly. Even the most basic dental services will cost you a significant amount. For instance, getting even basic cleaning can set you back a couple of bucks. This is where dental insurance comes in. With a comprehensive dental cover you can access regular dental care. 

It will ensure you seek immediate help whenever you need important oral healthcare for gum problems or cavities. However, dental insurance policies differ from one provider to another. Most affordable ones are limited to basic dental procedures. But, don’t let this discourage you since even basic dental insurance is better than none at all. 

The Basics of Dental Insurance 

Dental insurance policies focus on helping you pay for different crucial dental procedures which would ordinarily cost you an arm and both legs  if paid  for out of the pocket. Your policy will determine whether the provider pays for all or part of the work done by your dentists. These include routine cleanings, X-rays and even implants. Dental insurance policies typically have lower premiums than health insurance. However, they work in an almost similar manner. 

Most dental insurance policies follow a 100-80-50 coverage structure. Health insurance covers on the other hand, cover a significant percentage of even huge expenses once the deductible has been paid. Similarly, they have a yearly out-of-pocket maximum, along with a $50 to $100 deductible. As you can see, the lower dental policy premiums come with a catch. 

Most dental insurance policies will cover all preventive care procedures such as exams, X-rays and cleaning for in-network dentists. Subsequently, they will cover 80% of most basic procedures such as fillings, root canals, and extractions. Finally, dental insurance will only cover half the costs for major procedures such as crowns, bridges, implants, and gum-disease treatment. 

Furthermore, some procedures are not covered at all by dental insurance. This is because most providers do not consider them medically necessary treatments. So, even with dental insurance, you cannot afford to splurge when it comes to dental care. The benefits of dental insurance will always depend on many factors. For instance, older people are more likely to benefit from these policies. The preventative care from dental covers will go a long way to keep them healthy. Similarly, most providers have custom-made policies for them. 

They focus mostly on their dental care needs. Examples of these needs are crowns, root canals, dentures, and tooth replacements. Note that these policies may also apply to other age groups as well. That’s why there are group insurance, individual and family plans. 

Indemnity Dental insurance Plans 

Indemnity dental plans are the most expensive dental insurance policies. Thus, it’s not surprising that there are only a few of them in the market. However most providers will refer to them as the “fee-for-service plans.” A common characteristic of these plans are the cost caps that they come with. 

You will find that a provider sets a limit for what they will cover for each dental procedure you get. In most countries, you will find that the relevant authorities have set a standard amount. This helps to protect customers from insurance companies. It also ensures that the dental insurance sector is adequately regulated. So, even with this insurance cover, you might still have to pay some amount out of pocket. 

Finally, one thing you should expect with indemnity plans is that the provider reimburses you directly. So, you have to pay the dentist with your own money and wait for the provider to reimburse you after filling a claim. The claim will be approved soon or later depending on your providers’ standard operating procedures. However, these plans are more flexible because you get to choose your own dentist. 

Preferred Provider Organization (PPO) Dental insurance plans

Preferred provider organization plans unlike the indemnity plans are much more common in the market today. Most people opt for these plans because they are way more affordable than the indemnity plans. Here, dentists will send an application to join the PPO network. They then agree on a fee structure with the insurance companies. 

One disadvantage of these plans is that they are less flexible since you cannot choose your own dentist. Using an out-of-network dentist means that you will have to pay for dental services out of pocket. 

Another disadvantage is that you might end up paying more than you would for an indemnity plan. This is because these plans also include certain administrative costs. So, you should find out from your provider before signing a contract. However, it might be worth it because some have a wide network. This gives you more choices when it comes to dentists. 

Health Maintenance Organization (HMO) plans

A health maintenance organization plan is another common dental insurance plan in the market today. The plan allows the subscriber to pay a monthly or yearly premium according to your agreement with the provider. The only disadvantage is that you are restricted to the network. 

Another disadvantage of this plan is that some might require you to live within the area where the HMO is offered.  However, don’t let this discourage you from subscribing to this plan. These plans are the most affordable ones in the market. The dentists will charge different fees for each service they provide. 

Important things to consider when choosing a Dental Insurance Policy

Since there are many dental insurance providers in the market, it’s important to research before settling on a provider. This might sound daunting especially if you do not have enough information on dental insurance policies. Let’s take a look at some of these factors. 

Check if the Provider offers a Group Coverage 

Most employers usually provide dental insurance covers as a benefit. Other group coverage programs such as AARP, Affordable Care Act or marketplace health insurance policies. Public programs also offer dental insurance benefits that might be helpful especially if you are in the military. 

The advantage of these plans is that you will get to pay less than you would for an individual insurance. Furthermore, they may also have better benefits than individual insurance. However, you should be careful before opting for these plans. You should check the premiums and ensure that you can afford it. This is necessary even with health insurance benefits offered by an employer. 

Employer benefits are the best though it might not cover all your dental needs. So, you should do some research and see if it’s the best for you. You can also compare it to the other policies in the market before making a decision. 

Analyse other Individual Policies 

Though individual policies are more expensive than group policies, they are worth considering. These policies also allow you to buy single or group policies depending on your preference. So, you can also get one for your entire family. However, there are also disadvantages to buying this policy. 

For instance, they have more limited benefits. With an individual policy, you will have to wait for some time when getting a major procedure. The provider usually takes time before approving the procedure. It means that you cannot rely on it for urgent procedures or during emergency situations. 

Providers will also ask you to wait for a while before accessing some benefits. This is because some people get the policies just to have major procedures. The waiting period can last as long as a year or just a few months depending on your provider. The waiting period will also depend on the procedures that you want done. 

You can also research and find out if there are providers or policies without a waiting period. You can, however, expect to pay more for these plans. So, shop and compare before signing a contract. Visit the websites of different providers to find out information on these policies before you decide. You can also contact your provider and ask for price quotes and policy details. You also have the choice of using an insurance agent or expert. 

Find Out Which Dentists Are in your Insurance Network  

Alternatively, instead of surfing the internet for the best provider, you can ask your dentist for help. You should find out which insurance policies they accept and see whether it is right for your dental needs. This is necessary if you don’t have an indemnity cover. PPO and HMO plans include a network. 

You can check out the list of dentists that are available in each network before you settle on one. These are the best plans for those who don’t have a preferred dentist. Getting a new dentist might also cost you extra money. The new dentist might suggest new procedures that might not be covered by your plan. 

There have been cases of dentists suggesting unnecessary procedures for their patients to make more money. Providers reimburse less for preventive procedures so most dentists try to make up for them. So, you should choose a dentist based on recommendations from a friend or neighbour. You should also be on the lookout for discount plans offered by different providers and dentists. 

Analyse and Understand the Policy  Entirely

Dental care can be expensive if you get a poor insurance cover. Thus, it pays to review each policy carefully before deciding. You should also base your choice on your budget and dental needs. Check if the policy will cover both normal and emergency dental care. As I mentioned earlier, regular dental care is essential to your wellbeing. 

If possible, find a plan that covers exams, cleanings, X-rays, fillings, tooth removals, root canals, gum cleanings, and denture repairs. You should ensure that you can access these services as soon as you subscribe to the insurance policy. You should check how long it takes to get major procedures. 

However, you will find that most policies need you to wait for a year before you can get benefits for dental implants, crowns, gum-disease treatment, complete dentures, and TMJ treatment. TMJ treatments entail problems with the temporomandibular joint, which connects the jaw to the skull. However, it will only cover half of the costs. 

Thus, when choosing a policy, you should consider how much you are willing to spend out of pocket. The bottom line remains that major dental procedures will cost you a significant out of pocket amount even with dental insurance. You should just remember that each policy has varying benefits which you must consider carefully. 

All Plans should Cover Preventive Care

When choosing a plan, you can weigh its legitimacy by checking if they cover preventative care. Regular checkups can be very expensive even if it’s done yearly or every six months. This is because a regular checkup should include cleaning, a visual inspection from the dentist, and x-rays.  It means that you might even end up spending more than $200 out of pocket just on a regular visit!

So, you should ensure that the plan you go for covers 100% of the cost when it comes to preventative care. You might also come across some plans that will only pay 60% of the total cost. I wouldn’t recommend such a plan unless there are other benefits that best suit your needs. You can also go for these plans if they are the best you can do on a budget. 

Consider Basic Restorative Care Coverage 

When you visit a dentist for services such as fillings, extractions and re-cementing, regular dental insurance policies cover 80% of the costs. This implies that you have to pay the remaining amount out of pocket. However, as discouraging as it may sound, this is a really good deal since you get to save either way. 

However, if you are in the market for composite or tooth-coloured fillings, you might be disappointed. Almost all the insurance covers that you will come across will only pay for amalgam (silver) fillings. So, you might have to find an expensive insurance cover or pay for the extra costs out of pocket. 

Ensure major Restorative Services are covered

It is common for dental insurance policies to pay for half the costs for crowns, bridges, implants, and root canals. So, you should ensure that your policy includes this too. The good news is that you might not need any of these services throughout your life. Or if you do, it might be a one-time thing. This means that the fifty percent covered by the insurance policy is still a good deal. 

Most restorative services are very expensive though the costs will differ from one dentist to another. For instance, a root canal might cost as much as $2000. Imagine if you had to pay all that out of pocket! You will be glad your insurance covered half the cost. A toothache is already painful enough. So you shouldn’t have to worry and stress about the cost too. 

Corrective Services Aren’t Typically Included

The one downside to dental insurance is that they hardly ever include corrective services. This can be disappointing but I guess the advantages far outweigh the disadvantages. So, if you are in the market for braces or other orthodontia, you might have to consider other options. 

For instance, you can buy a rider policy if you don’t find a plan that covers these costs. You should be ready to pay more with a rider policy. However, don’t give up just yet. They are just a few bucks more expensive. So, chances are that you can afford it. The downside is that they will only cover half the costs. 

Consider the Waiting Period of each Plan 

As I mentioned earlier individual plans and some group plans have specific waiting periods. So, you should not expect to have all your dental work as soon as you subscribe for an insurance cover. The good news is that you can still access preventative care since they are covered immediately. I should also let you know that some policies will still have a waiting period of 30 days for preventative care. So be sure before you purchase a policy. 

Similarly, a good policy should have a maximum of 3 months for basic restorative services and 6 months for major restorative services. So, always confirm which dental services each policy covers in a year. Go for affordable and flexible policies that cover as many services as possible in a year. This will save you a lot of money and stress. 

You should also know that though some policies only cover a few services every year, they might best meet your needs. So, you can also compare them to the other ones and decide which is best. However, the best way to save on dental costs is to have regular check-ups. This will also save you from the pain that comes with toothaches.