Dental insurance is not typically included with your major medical policy, so you usually have to purchase it separately as a supplemental plan. Most supplemental dental insurance plans are categorized as either indemnity or managed-care plans. The kind you select will affect your choice of dental care providers, out-of-pocket costs, and how your bills are paid.
Indemnity plans offer a broader selection of dental-care providers than managed-care plans. Indemnity plans pay their share of the costs for covered services only after they receive a bill (which means that you may have to pay all of the costs up front and then bill your insurance company, which then reimburses you for covered charges).
Managed-care plans typically require you to use a dental provider network. Dentists participating in a network agree to perform services for patients at pre-negotiated rates and usually submit the claim to the dental insurance company for you. Managed care plans typically come in two varieties: health maintenance organization plans (HMOs) and preferred provider organization plans (PPOs).
In general, you have:
No matter what type of plan you select, it’s important to investigate the waiting periods required by different plans for specific procedures. Some plans don’t cover major procedures immediately and could require you to wait between six to 18 months. This is also why you might want to have dental insurance well before you absolutely need it.
HMO, PPO, and indemnity plans provide a great deal of options when it comes to monthly costs, deductibles, and covered services. Be sure to choose the plan that best meets your needs.
With the implementation of the Affordable Care Act (ACA), also known as Obamacare, dental coverage is considered an essential benefit for children under the age of 18 and insurance companies are required to offer this coverage for kids.
This means that if you are obtaining medical coverage for your kids, you must be offered a dental policy to purchase at the same time.
However, you are not required to purchase dental coverage, either for your children or yourself. Obamacare doesn’t require that everyone have dental insurance, only that children be offered coverage. So you won’t be subject to the tax penalty if you and your family decide not to enroll in dental coverage.
Depending on the particular dental plan you select, many regular dental procedures may be covered. This can also depend on how long you have had your plan and what percentage of certain procedures is covered by your plan.
The cost of dental procedures also varies according to your location and the type of procedure you need. If you have a deductible, you normally have to pay that amount before the insurance company covers any benefits.
Nearly all dental insurance plans cover basic treatments such as checkups, X-rays, and cleanings. Depending on your plan, you may also be covered in full or partially for:
Cosmetic treatments typically aren’t covered by most insurance plans. For instance, you can have your teeth whitened, veneers placed, and gaps fixed, but you will likely pay the full cost for those procedures.
By purchasing supplemental dental insurance, you are safeguarding your and your family’s health, as well as your finances. If you want to further explore your dental insurance options, please visit our dental insurance page to compare all of the different plans available.