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The Basics of Dental Insurance

While major medical insurance is the bulk of what people are most interested in, other types of insurance do come into play. Life, dental, and vision are other types of insurance that can be talked about in conjunction with health insurance, with dental usually being the most prevalent of the three.

Dental Insurance is offered by many companies, and not just ones that sell major medical insurance. Companies that sell only supplemental insurances to major medical plans sell dental as well. This leaves the consumer with a ton of options to sift through for dental insurance. And while some of the options are obviously better than others, it will really depend on what you personally are needing out of the dental plan to lead you to the option that is best for you. But, before you shop for dental, there are some things to consider.

Who needs dental coverage?

If you have dependents under 19 on your major medical insurance plan, you need to see if your plan includes dental coverage for them. If it does, you would only need to purchase dental coverage for anyone over 19. A lot of the ACA plans include dental and vision for children on the major medical plan at no extra cost.

What kind of coverage do I need?

Do you only typically see the dentist twice a year for cleanings and have no reason to think that you would need to have any major dental work done in the next year? A preventative only dental plan would include coverage for routine exams and cleanings, and the routine x rays that accompany them. If you want to cover yourself for minor services such as extractions, fillings, or non routine x rays, or major services such as root canals, bridges, or crowns, you would have to get a more comprehensive dental coverage.

How does dental coverage work?

Across the many different options for coverage, they all work mostly the same. Typically, there is a deductible (usually $50-$100 for single person coverage, sometimes waived for preventive services) and an annual maximum that the carrier would pay for expenses (usually between $1000 to $1500). Waiting periods are commonly seen on dental policies, usually 3 to 6 months for minor services, and up to 12 months for major services. Orthodontics are usually not covered, although some plans will offer some coverage or discounts.

Network Reminder:

Just like major medical insurance, dental coverage uses networks as well. Some dental plans can be PPO’s, with in network dentists being cheaper than the out of network dentists. It is very important to make sure that you are selecting a plan that has your dentist in network if you are not willing to switch dentists. If you are okay with making a change, you would want to select from the dentist provider list from the dental insurance carrier’s plan that you purchase.

Other Considerations:

Also, remember, you may be balance billed for any charges that fall outside of what your dental plan pays for, even for covered services. If the dentist charges more than the maximum allowable charge for a service that the plan will pay, then the remainder of the charge will be billed to you.

Enrollment into a dental plan is not contingent on the annual Open Enrollment. You can enroll in dental at any time during the year, with most plans starting on the first of the month after you enroll. Payment is usually needed at the time the application is submitted, and some plans require that a recurring automatic payment is set up.

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