This time of year we all need to muddle our way through “open enrollment”. Included in this decision may be which (if any) dental coverage you should choose. We would like to help take some of the guess work out of this process. Below is a list of things that you should consider to help you determine what would be the best insurance for you. Your decision can be based on what you know about your dental health, your dentist can give you some guidance with this.
- Overall cost of plan
What is your budget for dental care? Remember to consider the cost of your regular preventive visits without insurance. According to the American Dental Association1 the average cost of one dental cleaning and exam is $130.00 not including x-rays.
- What is covered?
Does the plan cover preventive only (cleaning and exam)? This is very important in determining if insurance is worth it for you. Find out what services are covered (fillings, crowns, etc.).
- Is there a wait time? Or a deductible?
Many dental plans have what are considered “wait times”. This is the amount of time you must be enrolled in your plan before benefits (other than preventive care) are available. Many stand-alone dental plans or plans being offered as part of a medical plan, especially Medicare Advantage have these stipulations.
There are quite a few dental plans that will not cover fillings for 12 months.
Some will not cover major work (crowns, bridges, partials & dentures) until 24 months of enrollment. Coverage for implant services requires special attention. Also, consider the percentage of the cost that will be covered: Fifty percent of a $300.00 filling will leave the patient with a payment of$150.00 and if there is a $50.00 deductible, the patient responsibility may be more than the cost of the original premiums!
- Is your dentist in network? Can you go out of network?
- The questions above help you determine if you will receive benefits with the dentist you know and love!Insurance companies may have a “network” group of dentist with whom they have contracted. The insurance plan can stipulate that you will only receive benefits if you work with a network provider.
- If there are out of network benefits, how will they pay? Many companies only pay to the patient for out of network care.
We hope we helped to clear the fog! Let us know if you have other questions.
We may have some options for you.