Dental Insurance 101

Understanding your dental insurance is just as important as receiving quality dental care. Many people have had dental insurance for years, but few of those people actually understand what it is they are getting when they say they have dental insurance.

The problem is no one wants to deal with the complicated legal jargon and technical details associated with better understanding their insurance plan, and there are so many different options out there. However, it is important to both you and your health that you get a better understanding of dental insurance.

The first thing you need to know is that all insurance is not created equal, and dental insurance is not like other insurance. In fact, dental insurance is not run like auto or home insurance or even your other medical insurance. This is mostly because dental costs are much more predictable and routine than a car accident or broken bone, so there is no need to protect from unseen expenses. As a result, dental insurance should be thought of less like insurance and more like a coupon that gives you a discount on services provided to you to offset the costs.

Secondly, you need to understand what your personal policy plan covers and what percentage of each of these services are covered by insurance. For example, your plan can cover routine care, treatments, oral surgery, orthodontics, and more all at different percentages. While routine care might be covered 100%, orthodontics might only be covered 50% or not at all. The percent discount you get off of the usual fee for a service is your deductible, and the remaining amount you have to pay is your co-pay. If you have 100% coverage for your fluoride treatments for example, your co-pay would zero.

In this way, you should choose a dental insurance plan based on need. If you have children that are going to need braces over the next few years, a dental insurance plan that covers a higher percent of the cost of orthodontics might be beneficial even if the plan covers a smaller percent of the cost of your routine visits. In general, most plans do cover the basics such as routine visits, but not all policies cover services such as fillings or crowns or orthodontics. For this reason, it is necessary to examine policies closely.

It is also important to keep in mind however, that all dental insurance policies have a cap or a maximum amount of benefits you can receive in one year. If you go over that cap, you then personally will have to pay for any expenses over the maximum.

Thirdly, many people find that their plan requires them to see a specific dentist within their insurance provider’s network. This can sometimes cause people need to switch dentists in order to get full coverage from their dental policy.

In this situation, it is important to examine the benefits and disadvantages. Sometimes it may be worthwhile or financial necessary to switch dentists if this is the case with your insurance policy. For others, if you are getting high quality dental care, staying with your existing dentist, even when they are not included in the insurance provider’s network, may be worth paying more for their services and getting less of a discount. At that point however, it might now be worth paying for insurance.

Finally, you should always feel comfortable talking to your dentist or their staff about dental insurance. They will be happy to answer your questions and will do their best to help you find the answers you need if they do not know the answer. You only deal with dental insurance a few times a year, but it is there job to know about dental insurance and to help you make educated decisions about your dental health.

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