All you need to know about Dental insurance.
Dental insurance is a type of medical insurance cover for your teeth and gums, also known as a dental plan, which also caters for preventive procedures such as yearly cleansing.This insurance include kids insurance and adults cover. Some employers don’t include dental plans in their employee medical coverage but it is often available for customers either together with medical cover or separately as dental insurance. This cover ensures that an individual has a great smile and thus the saying a smile is worth a thousand words. It helps patients to have a clear budget of what every procedure will cost as it is clearly outlined.
How Dental Insurance works
Private dental plan system requires the individual to choose the insurance plan that your preferred dentist is on and choose what you can afford to pay in the long run. If your preferred dentist is already subscribed to the insurance company then all you can do is choose an affordable plan. Just in case you do not have a preferred dentist then you need to go to the insurance company’s portfolio and choose a dentist with an affordable plan.
If your preferred dentist is not subscribed to the insurance network then you will have to incur an additional cost to be able to use your dentist, it will be cheaper to choose a different dentist who is subscribed to the insurance. When calculating the monthly premiums several factors are considered such as the dental plan chosen and where you are located. Regardless of whether you use it or not insurance premiums are supposed to be paid on a monthly basis.
Most insurance companies put waiting periods on dental plans lasting up to six or 12 months before they can be used to cover for dental procedures. Some even put a requirement of up to two years before they authorize any major dental work to guard against individuals who may take dental insurance just as a backup to already planned dental procedures. Other companies such as Spirit dental are slightly flexible and can ignore the waiting period to its long term policy holders who can pay the discount fee. This will get the client direct qualification for dental procedures like root canal and other oral surgeries without having to wait for the whole waiting period to lapse. This can be very helpful for clients who are in urgent need of a dental procedure and cannot wait.
A deductible is the minimum amount an individual is supposed to pay the insurance company in order for that insurance cover to cater for the medical expense. An example is when a deductible is estimated at $300 and the dental procedure costs $220 the insurance cannot cater for this and the individual will have to pay for the entire cost of the procedure.
When the person has paid his premiums until it has equaled or surpassed the deductible amount the insurance company caters for the medical expense but most policies do not cover 100%. A coinsurance is the percentage of the medical expense that the patient pays after insurance has covered the rest.
Dental Procedures Categories
There are three categories for dental procedures that are usually covered by dental insurance: Preventive procedures which include annual visits for dental cleaning, x-rays and sealing. These procedures are usually covered in full by a majority of insurance companies. Basic procedures includegeneral treatment for gum disease, extractions, fillings and root canals. A majority of insurance covers only 80% of these procedures with the rest being covered by the patient. Major procedures such as inlays, bridges and crowns are covered by half of the cost while the other half is paid for by the patient.
When deciding on which dental policy to take up it is important to check and verify closely about which procedures they consider as preventative, basic and major because they differ across various dental insurance companies. Some insurance covers consider root canals as a major procedure while others will categorize it as a basic procedure meaning they will differ on how much cover they will offer on both policies.
Generally most insurance companies do not cover expensive cosmetic procedures such as whitening or implants because these procedures are not considered medical emergencies but just ways of creating a better smile. Other reasons for not being included in many insurance policies is because procedures such as an implant is very expensive and sometimes may cost more than the deductible which will mean that any basic dental insurance will deem it over the cost and the ones that include it in their policies will only cover it up to a certain cost limit.
How to get a dental plan
Getting a dental cover can be so expensive especially if you already have a health insurance plan but it doesn’t cover dental. Then when you actually get dental and you pay your monthly premiums but you never need any dental procedures done but you have no choice but to pay. Sometimes you even reduce the amount of deductible you are required to pay because you don’t seem to require any dental service and then you get a toothache and now your policy has reached its limit and you are now required to pay the rest of the cost out of pocket.
To avoid such issues you need to compare various insurance companies, get their quotes, understand their policy terms and what they offer. You need to understand that you are taking that dental policy for future dental services that will be covered after the waiting period is over or you just get a policy from an insurance company that operates without a waiting period. You need to understand that dentists working within a certain insurance network will charge differently from those that are outside the network.
What are three different categories of dental insurance plans:
1.Indemnity dental plans: This is a more expensive plan and it may require you to pay for the service and then you file a claim which the insurance company will refund you the difference. The advantage here is that you can choose any dentist you want and they don’t have to be in the network.
2.Preferred Provider Organization (PPO): Here it works by dentists choosing their network and they come to an agreement about their charges. These dentists will cost less than the ones not on the network.
3.Health Maintenance Organization (HMO): This one requires a client to tender monthly payments that will ensure the use of the network only.
Best Dental insurance companies
There are many dental insurance companies to choose from but the following have been rated among the best in offering great customer service, best value for money and a wide range of cover.
Cigna is a worldwide dental insurance company operating in 50 states in the United States with over 93,000 dentists in its wide network. They are available on call around the clock. Cigna has an affordable system for its clients who are given no copays and no deductibles for them as long as they use a dentist who is in their network. There is also a Preferred Provider Organization (PPO) plan which is offered to all its patients and each person is charged monthly and individually.
Each individual is given an option to pick a care based on the person’s healthcare need such as an orthodontic care which may be covered depending on the policy taken. For example if you take a Cigna dental 1500 plan all basic, preventative and orthodontic care will be covered at $35 per person monthly. Any lower plan than that will only cover basic and preventative procedures like routine teeth exams but not orthodontic care.
Renaissance dental is a health company based in over 50 states in America with a wide network of over 300,000 offices that offer dental services. It has a great rating among its customers for their excellent customer services and an A+ rating for their record in settling financial claims so this means that they have a great financial setup. The dentists they have on the network can help you raise a claim. They offer a wide range of dental plans tailored to cater for different needs for families and per person care.
This company also offers free online quotes which relieves clients of the hassle of moving from one dental practice to another when trying to check for prices. This also helps those clients that live far away and maybe travelling so as to check if where they are going the dental policy costs the same. Some of their plans do not cover preventative procures and also has waiting periods for its major procedures. Their yearly benefits are only able to cover a maximum of $1000.
This is a dental health company that operates in 50 American states. It has partnered with Ameritas life insurance thus giving them one of the best rated customer service rating and a great rating of financial assistance. This also gives them a wide range of dental professionals in the country numbering at 111,500. It has the lowest deductible of $100 which is actually paid once unlike other companies where you have to pay an annual deductible. Another great advantage with Spirit dental is that there is no waiting period for their dental procedures.
They offer a fair coverage for all clients and they even offer coverage for major procedures. They offer up to $5,000 total annual maximum benefit for clients who have been loyal to them past 3 years. Some of their dental plans helps to cover for cleaning 3 times in a year, orthodontics for children and preventive care. Spirit dental may offer you a choice to choose either network dentists which will be cheaper or your own dentist but the charge will be dependant with your location.
Humana dental is a dental health provider which operates in 50 states in the U.S. It has one of the best value for money ratings nationwide due to its small startup cost and in some of their dental plans their deductible is payable once unlike other insurance companies whereby their deductible is paid every year. In some of their dental plans they have a lifetime deductible of $50 for one person and $150 for a family plan. Another great thing about Humana is that their preventive procedures are covered by them in full. They have a wide range of network coverage with over 270,000 specialised dental professionals across the U.S.
Their major dental procedures have a waiting period depending on the dental plan you are on. Humana also has Preferred Provider Organization (PPO) plans which helps reduce the price for patients with not normal dental conditions. They have a great rating among customers about settling their financial claims and thus have a strong financial setup. They are located all over the 50 states and they offer a wide range of policy coverage and different dental plans specially formulated for different client portfolio but their pricing will depend on your location.
Their maximum benefit limit varies between $1000 and there is another one for unlimited which will be highly dependant on the policy that you pick.
United Health One Dental
This healthcare insurance company is owned by United health group. It offers one of the best family health care coverage due to its dental plans that have no age limit and they also offer orthodontics to kids. A majority of their plans also offer full coverage for preventive procedures without any deductibles or waiting period which is very cost effective to families. The company also has a very good rating of its clients financial claims which means that your teeth are in safe financially capable hands. It has a wide range of coverage with many dental professionals scattered all across the 50 states in the U.S.
Their dental plans and maximum benefits amount can vary greatly all across the continental U.S. according to where the patient is located. This is however in no way a hindrance to this insurance policy because they have made it easily accessible to get a free online quote from wherever you are. In some plans dependant on where the patient is or what basic or major procedure they plan to undergo there is usually a waiting period which varies between 4 months or more. Depending on the type of cover taken this policy may cover orthodontic procedure for kids while those high level plans will cover major procedures. This insurance cover usually has an annual maximum benefit coverage of $1000 and some plans will cover up to $3000 on patients who are on their third year.
Physicians Mutual Dental
This is a dental insurance company found in all 50 states in the U.S. It is the best dental cover for senior citizens in the U.S. because it doesn’t have a limit on its cover without any deductibles. It covers some dental procedures while giving special considerations to how much they charge the elderly to make sure seniors can afford it.