The most important option to consider when selecting a dental insurance plan is the yearly maximum benefit amount. This benefit ranges from $750 to $2500 per year. Some companies will let you use up your benefit amount as you need it and accept almost all charges due to your dentist but most will follow a payment (up to your yearly maximum). With a payment schedule, you will only have a certain amount to spend per procedure and be responsible for the rest. Note that, in all cases, when procedures are considered major, a waiting period will apply before any benefits are paid. For your yearly maximum, we recommend that you select a minimum of $1,000 to $1,500 in benefits. The price difference is usually small and most people use up their benefit.
Deductibles can also vary greatly. With some insurance carriers, dental insurance deductibles can be as simple as $100 per year deductible that just needs to be met one time, while other insurance companies will have a more complicated system of deductibles such as a $50 deductible for each procedure other than a basic cleanings. Carefully check the deductible for the plan you select. What may appear as a good buy may end up being very expensive after deductibles are considered. The best option is a onetime $100 yearly deductible even if it also applies to basic benefits. This will keep your plan simpler and likely cheaper to administer.
Procedures and common plan coverage
For basic dental and preventative exams which may include some x-rays there is usually no charge to you from your dentist (except possibly a deductible). That is probably the only procedure that will be covered at 100%. Anything else such as more comprehensive exams, endodontics, periodontics and prosthodontics will have more limited coverage and lower benefits. Choosing features depends on your dental health and history. Look at you family history and your personal eating and mouth health habits. If you are likely to run into major dental health issues we recommend you select a plan that covers those particular major dental issues. As an example, if you take good care of your teeth but you have a family history of periodontal (gum) disease then you may want to make sure that your dental plan covers this condition. Note that, although, mouth shape and teeth positioning are hereditary, cavities are not hereditary – cleaning your teeth is your best insurance!
Rates will vary greatly by company, where you live and plan benefits and deductibles. Beware of administration membership fees which are not always spelled out until after you have selected the plan you want and are ready to pay. You may get a discount by paying yearly but rarely by paying quarterly or bi-yearly. In most cases, it seems that the monthly auto payment plans are the best as they will tend to cost the same as yearly pay plans and you are not as likely to lapse your dental plan policy for none-payment.
Do you need an agent?
Our experience has shown that most people do not need an agent to find and apply for dental insurance. At best, a quick call to the company offering the plan options is all that should be needed. We have also found that online shopping and applications yield lower and better results. Shopping with two to three web sites that offer dental insurance is recommended.
There is no point in getting a great dental plan if you will need to drive 30 minutes or more to get to your favorite dentist. Unless, of course, he or she is the only one you trust. Most dental plans offer very large dentist networks and it is very likely that you favorite dentist is in the one of the networks. You should be able to easily check online before you even apply for any plan. If a network list is not made available online, you may want to shop from another dental insurance website.
The dental discount plans alternative
If you have looked at standard dental insurance plans and none of them meet your needs or the price is too high, you may want to consider a dental discount plan. Some are great while some are worthless. Discount plans are usually much simpler to administer than a standard dental plan as they do not usually require that claim forms be filled out. Here is what you want to consider when selecting a discount plan:
· Dentist network (check to see if your favorite dentist is in)
· Procedure covered under discounts (covered procedures should be covered and available for discount right away. A list should be offered before you buy)
· Discount amount per procedure (That number can vary greatly)
· Yearly usage limit if any (there should be none)
· Yearly cost (should be much less than a regular dental plan)
· Any deductible or waiting period? (should be none)
· Reputation of company offering discount plans (check at least with the BBB)
Note that a discount plan is cheaper for a reason. The insurance company is not paying the dentist for any dental procedures, cleaning or other dental work and has just negotiated with dentist to offer discounted rates to their members. If you have a good relationship with your dentist, you may be able to get the same or better discounts by just asking your dentist and without buying any dental discount plan.
Should you get any type dental plan?
If you are asking then it is likely that you or someone close to you have never had any major dental health issues. If you are a saver, meaning if you save money on a regular basis for dental care, then you probably do not need a dental plan. If, like most people, you do not have a savings plan for your dental care, then we recommend that you get dental insurance or at least a quality dental discount plan. Although you may have healthy teeth today, tomorrow may be another story and you will be more than happy to have a good dental plan when it’s time to visit your dentist. If anything, people who have dental insurance are much more likely to see their dentist for regular checkups than people who do not. More checkups usually means better mouth health.
We hope this article has given you a better sense of the value of having or not having dental insurance. Please always feel free to ask us questions. Be well!