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How Can Dental Insurance Protect You?

Thursday, June 24th

How Can Dental Insurance Protect You?

The American Dental Association recommends seeing a dental professional at least once every six months for a cleaning and exam. Good dental health can help to prevent several other health issues, including heart disease and diabetes.

Dentists prefer to prevent dental problems, rather than simply fix them after they occur. Regular dental check-ups allow dentists to identify signs of dental disease before they progress, making them more difficult - and expensive - to fix.

Many people avoid going to the dentist for financial reasons. The average cost of preventative dental services, including exam and cleaning, depends on the area in which a person lives. Annual cleaning and exams run between $100 and $200 per visit. Add in dental x-rays ($30 to $100) and topical sealant used for children to help prevent cavities, and a routine visit can push close to $300.

In comparison, 42 percent of Americans do not have any form of dental insurance, making even a $100 visit to the dentist unaffordable. Those who do have dental insurance generally have it through an employer. However, there are many options on the market for those who wish to purchase their own dental insurance. The cost of the plan depends on the coverage included within it.

Most dental plans are set up in a similar fashion as health insurance plans, offering monthly premiums, deductibles and covered services. Some dental plans offer networks of approved providers at a savings. There are several kinds of plans available:

  • Preferred Provider Organization, or PPO. This type of plan offers a network of dentists who have agreed to accept payment at contracted rates from the insurer. PPO plans generally have a deductible that must be met prior to the insurer picking up the additional cost. Once the deductible is met, plans which reimburse 80, 90 or 100 percent of the cost are available. This plan will protect the patient by allowing them to know up-front how much they will be expected to cover out-of-pocket at the dentist each visit.
  • Discount Provider Organization, or DPO. These plans provide dental professionals who are willing to provide their services to patients at a discounted rate for a monthly or annual fee. This kind of plan generally does not include a deductible or payment plan; however, the patient will be responsible for the majority of the costs.
  • Dental Health Maintenance Organization, or DHMO. This plan is the dental equivalent to a medical HMO plan. DHMOs do not generally have deductibles, but rather use a co-pay system that determines the amount of money the patient will be responsible for paying at the time of service. Only dentists within the DHMO network may be used with this plan; otherwise, the patient will be responsible for the full out-of-pocket expense of the visit.

While no dental insurance plan is perfect, the alternative is less desirable. Allowing your dental health to erode to the point of needing major dental repairs is never a wise - or financial sound - decision. The more damage you have to your teeth, the more expensive the bill will be, with or without insurance. The best way to use dental insurance to protect your teeth and mouth is to take full advantage of it, engaging in preventative visits for routine check-ups and cleanings.

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Dental Insurance Plan FAQ

If you already have dental insurance through your employer, you won't need to get coverage separately. But, if you're like the millions of Americans who don't have access to dental coverage through their job, it's worth it to consider buying a dental plan privately. Oral health is very important in your overall health, and twice-yearly checkups are recommended for everyone. Having dental insurance can make routine visits and services like root canals and cavity fillings much less expensive.
That will depend on the plan you choose, but most cover routine well visits like cleanings and X-rays. You'll also typically have coverage for fillings, crowns and other issues with your teeth; how much you'll pay out of pocket is based on your specific plan limits for each procedure and your total annual limit.
Many dental insurance plans don't cover removal of wisdom teeth or orthodontic treatments. However, coverage with higher premiums may include those procedures; if you've got multiple children in the family who might need them, it's worth finding a plan that pays for some or all of it.
You might be surprised at how affordable it is. Many individuals and families can get good coverage for less than $20/month.
You've got a lot of options. First, determine if you need individual or family coverage. Next, decide how quickly you want your dental insurance to start: some let you begin your plan on the same day, while others may have a delay of a few days or more. Then, choose what level of coverage you need and select the dental insurance plan that fits your needs and your budget!
Possibly. Most dentists accept insurance, but not necessarily all providers and plans. If you have a dentist you love, ask him or her which plans they take (and even which ones they like working with the most!); you can choose your insurance based on keeping your dentist.
As you might guess, dental insurance is traditional coverage that usually includes 100% of the cost of two preventative visits each year, lowers the cost of dental procedures, and often has an annual maximum dollar amount of coverage per year. Discount dental plans usually are lower in cost but give you less coverage: you may only save 10% on the standard cost for a filling or routine X-rays, and you will probably be limited to a single dentist instead of a network.
Absolutely. Most of today's most popular providers of dental insurance make it easy to pick a plan and pay for it online. If you don't have a specific dentist or insurer in mind, you might want to try using a referral site that gives you quotes from multiple companies and lets you compare your options side-by-side.
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