Dental Insurance

The Guide to finding your dental insurance plan

Find the Perfect Dental Insurance Plan

Good oral hygiene can prevent tooth decay, gum disease, bad breath, and improve your overall health. That is why it is important to invest in dental insurance or a discount plan at a minimum. This ensures good dental health for the future.

With the right dental plan, you can make your oral hygiene the best its ever been. You will also avoid costly treatments and painful procedures later on.

Dental insurance gives you the ability to receive preventive care and basic procedures for your smile. Each plan will offer families and individuals different amounts of coverage they need. Premiums, copayments, deductibles, maximum annual limits all vary with each company and specific plan.

Overall, dental savings plans or insurance policies can save you and your family when it comes to expensive procedures or even regular checkups. We know how to get you in touch with a great dental provider in your area. Here's everything you need to know about how to find the dental insurance plan you need.

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All About Insurance

The following terms are commonly used by insurance companies to describe their dental plans.

Deductibles

Deductibles are a fixed amount of money a customer must pay before their insurance company begins to cover care. With a deductible of three thousand dollars, the patient would pay that amount, and then the insurance company would pay after. After the deductible is paid, you typically only pay a copayment or coinsurance for services that are covered.

Keep this in mind: a lot of plans pay for services like routine cleanings before the patient has paid the full deductible. It is crucial to check the details of your plan to know exactly what to pay. Plans may even include separate deductibles for things like prescriptions. Also, family plans usually have both an individual deductible and a family deductible

Copayments

A copayment is a fixed amount that you pay for a service after the deductible is paid in full. Copayments often vary for different services within the same plan. Plans with lower monthly premiums generally require higher copayments, while those with higher premiums offer lower copayments.

Allowed Amount

The allowed amount is the maximum amount the insurance company decides it will pay for a service that is covered under the plan. If your health provider charges more than the allowed amount, you may be required to pay that difference.

This is also known as the network discounted rate you may receive if you have to pay out of pocket for covered procedures

Maximum Annual Limit

Basic dental insurance policies have a maximum amount in costs. This means insurers will pay a maximum fee for treatment in a year, called the maximum annual limit. Typical annual maximums can range from five hundred dollars to fifteen hundred dollars, and even more.

In some cases, insurers will not subtract the cost of your cleanings and routine checkups from the annual maximum. If you hit that maximum number you will be required to pay for any additional dental treatment you receive in that year out-of-pocket.

Rider Policies

Dental plans tend to only cover basic care and preventive care, not more expensive and costly treatment. This is why orthodontia, dentures, implants, or other advanced care is not covered under a basic insurance agreement. Rider policies are used to supplement the existing policy and add benefits for the insured. For example, in some areas you can get a rider policy to cover orthodontic services to avoid paying out-of-pocket.

Services not covered by your policy are usually because they are expensive, so it is important to plan ahead and buy a rider policy if you are expecting to need one.

Network Dentists

A network is a group of medical providers. A dental insurance company uses a network to give clients a convenient place to see the dentists that will accept their insurance. If you visit a dentist that is outside of the network, that does not necessarily mean your services will not get covered. However, the coverage will likely not be as high as if you visited a dentist within the network, nor will you receive the network discount negotiated by your insurance company.

Preventive Care

Preventive care is included in almost every dental insurance policy because this care is needed to prevent costly dental issues in the future.

Preventive care for dental companies includes:

  • Cleaning
  • X-rays
  • Exams

These visits are almost always paid in full with an oral health plan or a small copayment.

Basic Care

For dental insurance companies, basic care includes procedures like tooth extractions and fillings. Depending on the plan, root canals may or may not be covered under basic care plans. Just like for every dental insurance plan, the insured will have a copayment or coinsurance amount they are responsible for.

Major Care

Major care is covered to a lesser extent by insurance companies because major care is more expensive and involves more extensive treatment. In many plans, there is a separate lifetime maximum amount of coverage for major care, which includes services like crowns, bridges, implants, or dentures.

It is important to note that most cosmetic procedures are not covered under most dental insurance policies because they are considered non-essential to the patient's oral health.

Savings Plans

Dental savings plans, also called dental discount plans, are flexible and cheap alternatives to traditional dental insurance. With this plan, you can expect ten to sixty percent savings for dental care. Discount coverage resembles a members-only club, where you join the club and get discounts exclusively for members. However, if you require a more expensive procedure or different oral health care, your dental savings plan may not be able to offer you a lot of savings.

Waiting Periods

The waiting period for dental insurance is the amount of time you must wait before you can receive full coverage. During this period, your insurance company will not pay for certain procedures. These can last anywhere from six months for basic services to a whole year for major services, depending on the plan you have selected. The terms of waiting periods depend on the individual company and how they offer their plans.

Sometimes, if you are purchasing dental insurance because you no longer work at a job you used to work at or because you moved to a new area, you can bring this to the attention of your new company. They may waive one or more of the waiting periods and allow you to have access to full dental benefits sooner.

Coinsurance

Coinsurance is the percent that you pay for a service that is covered after you have paid the deductible in full. For example, if your coinsurance is twenty percent and you paid your deductible, then you would only pay for twenty percent of the cost of the approved services. If your deductible is not paid in full, then you have to pay the deductible first and then twenty percent of the remaining balance.

In general, low monthly premiums come with a higher coinsurance and lower maximum annual benefit, and high monthly premiums come with a lower coinsurance and a higher maximum annual benefit.

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Frequently Asked Questions

The questions below are commonly asked by people about dental insurance and various plans.

Can you go to the dentist without dental insurance?

Just because you may not have dental insurance, that does not mean you cannot visit the dentist. It may be helpful for you to schedule an appointment without insurance to get recommendations for oral hygiene and preventive care.

If you have access to an affordable dentist, you are able to visit with no insurance and pay a lower price than if you were visiting a regular dentist. Many dentist offices offer payment tier plans designed for those without coverage. Some clinics are affiliated with dental schools, and are great for high quality, inexpensive dentistry. If you visit this type of clinic, dental students will perform procedures under supervision of senior dentists. Government assistance may also be helpful for lowering the cost of a dental visit.

Can you get dental insurance anytime?

Some dental plans do not offer immediate coverage. In this case, you would have to wait to use your plan. A select few of these have a waiting period of six months or even a year.

There are coverage options available with no waiting period:

  • Group plans
  • Preferred provider organizations
  • Discount dental plans

Who has the best dental insurance?

The best dental insurance is subjective and varies from person to person. If you have healthy teeth and are only in need of routine checkups, then a basic dental plan would be right for you.

If you are an older person or have a history of oral health issues, a plan with higher coverage might be better.

Can I buy dental insurance only?

Yes, dental coverage can be bought separately from health insurance.  Visit Beacon Point Insurance for more information

Does Obamacare cover dental?

Yes, if you are under 18, you can get dental coverage from a few of the plans under the Patient Protection and Affordable Care Act.

However, if you are over 18 then you can purchase a stand-alone dental plan separately.

Some plans are available through healthcare.gov but we suggest you purchase dental insurance outside of the market place for better control and easier access.

Does dental insurance cover crowns?

Dental insurance companies typically cover mostly preventive services, like cleanings and x-rays. Crowns are considered beyond preventive care and are sometimes not covered, or you must pay a higher copayment for that service. This is because crowns are used to protect weak teeth or restore a broken tooth, not prevent further dental issues from occurring.

Look for a plan that covers Major Dental Services and you will have a better chance at finding coverage for crowns.

Is there dental insurance with no waiting period?

Yes, there are dental plans without waiting periods. Group plans, preferred provider organizations, and discount dental plans are some that typically do not have long delays.

Waiting periods are also referred to as elimination periods. It is important for policyholders to consider their expenses to pay for services while they are in the waiting period. The insured will not be able to file claims with the insurance company during this time period.

There are a few plans who will waive one or more of the waiting periods if you had previous constant dental insurance for the past 12 months.  Make sure to let the company know you had previous coverage, they may also ask for proof to verify.

Along with waiting periods, some policies may even create restrictions and more waiting periods to control how often they can receive specific dental treatments. A service like a denture replacement may only be allowed by the company once every few years.

Are dental discount plans worth it?

While dental discount plans are not traditional insurance, they come with dental benefits. Bottom line: they help you save a lot of money if you don't have access to a traditional dental insurance plan.

Instead of regular insurance, a dental discount plan gives you a discount card that allows you to access discounted prices on many treatments and services. This card can give you a percentage off the price of routine checkups or special rates.

Discount plans do not have limits on coverage either, so you can get as many covered services as needed in a year.

A drawback of these discount plans would be that for expensive teeth work, you may be responsible for the majority of the cost. So if you are someone that only visits the dentist for routine checkups, a discounted plan will cost you much less than traditional dental insurance until you need major services.

Does dental insurance really save money?

Yes, dental plans can save patients a lot of money, as long as they get a plan that suits their needs. If you or your family need extensive services and you have a low coverage dental plan, then you would be spending a lot of money out-of-pocket. Similarly, if you have high coverage and only need basic services, then you may be unnecessarily paying a high monthly premium. It is important to research each dental plan thoroughly and consider what you need before making a decision.

It is important to consider that high-coverage plans have high monthly premiums and low copayments and deductibles, whereas low-coverage plans have low monthly premiums but require higher copayments and deductibles.

When you look at the monthly cost of the better plans they most likely are much less than you think, typically only $2 -$4 per month per person to upgrade to a much better plan.

How do I pick a dental plan?

To choose the best dental plan for you and your family, you need to make a few decisions and considerations.

First, consider the needs of you and everyone else on the plan. Kids often need extra services like treatments with fluoride, sealants, and even braces. For adults, tooth sensitivity, gum disease, and replacing missing teeth are often what needs to be included.

It is also crucial to remember that insurance companies do not offer plans everywhere, so you want to check for the dental plans that will cater to your area. Only compare the plans that you can actually buy.

Also, look for a plan with a wider range of network dentists. If you do not like some aspects of your family dentist, then you should have the freedom to change offices.

It is easy to focus only on the monthly premium or payment, so think about deductibles, and the maximum annual limit. The maximum annual limit is the cap that insurance companies will pay for before you are fully responsible for costs. Because of this, make sure to pick a plan with a high enough maximum annual limit.

Ultimately, the right dental plan will be a combination of a reasonable premium, a wide range of doctors, and enough coverage to take care of everyone in the family.

Can I get dental insurance without a job?

Yes, you can buy dental insurance without first having a job. Purchasing an individual plan is always a choice.  

By purchasing an individual dental plan, you can keep it as long as you would like without regard to employment.

Is a dental plan better than dental insurance?

Dental savings plans are typically cheaper than dental insurance plans, which involve a monthly premium.

There are no deductibles or waiting periods with dental plans, so if you need coverage immediately, then a savings plan could be right for you.

However, for those unable to pay out-of-pocket for every procedure, a dental insurance plan might be the most appropriate.

Is it worth having dental insurance?

High-coverage dental insurance may not be worth it if you only visit the dentist to get checkups once a year or less. 

If you get your cleanings every six months then what you pay for dental insurance compared to what you would pay out of pocket is pretty close to breakeven in most situations.

Don't forget that insurance is in case something happens so you would have peace of mind knowing you have additional coverage if needed.

If you do not find yourself at the dentist's office often, then it may be smarter for you to buy a dental discount plan rather than a traditional policy.

However, it is good to have a dental insurance policy so you can pay lower rates for checkups and in cases of emergencies where you require care that is beyond preventive.

Can seniors get dental insurance?

Seniors can obtain dental insurance just like everyone else.

However, a lot of Medicare and Medicare Advantage plans do provide some dental coverage or only enough for preventive services. But, be careful because this can change from year to year.

Overall, it is important for seniors to have dental insurance and deal with dental issues from aging. Seniors can get discounted rates for their insurance because they must pay high premiums for services.

What's the best dental insurance for seniors?

Since seniors often need dental care, the best insurance for them would come with the most coverage, as well as low deductibles and copayments. Many companies offer plans for veterans and even loyalty programs.

Which is the best dental insurance?

The best dental insurance is completely subjective. The policy that meets the needs of you and your family is always the best choice.

Remember to consider how often you need dental services, the ages of you and your family, and whether the plan you're looking at has a reasonable maximum annual limit.

Consider deductibles and copayments when you are making your decision as well since you do not want to pay too much out-of-pocket if you have insurance.

How much is dental insurance per month?

On average, premiums for insurance can range anywhere from fifteen to fourty five dollars with an employer-sponsored plan. If you are buying individual coverage or family coverage, then the premiums can be somewhat higher.

Along with monthly premiums, you will likely be required to pay a deductible or copayment, which is separate from the premium.

Deductibles and copayments can be large amounts of money if you do not pick the right plan with the appropriate amount of coverage.

Overall, premiums, deductibles, copayments, and other insurance fees differ from individual policy to policy.

Is orthodontia covered under most dental insurance policies?

If you or your child is in need of braces or other orthodontic treatments, you probably do not receive coverage under a typical insurance plan. To supplement the coverage, you should buy a rider policy if available.

A rider policy adds benefits to or changes a simple insurance policy. It is important to remember that you cannot purchase a rider plan by itself, they must be bought as an addition to your existing policy.

Does AARP offer dental insurance?

AARP does offer dental insurance, through Delta Dental Insurance Company as the AARP Dental Insurance Plan. They have individual and family coverage that includes common procedures.

What do I do if I run out of coverage?

It is common for people to delay necessary treatments because of cost constraints. Some put off this care because of their insurance policy, while others could have used up their maximum amount of coverage for that year.

This is why it is important to pick the right dental insurance plan in the first place.

If you know you might need more extensive dental procedures, it is well worth it to pay for higher coverage instead of paying all of the remaining treatment out-of-pocket.

What's The Right Dental Plan For You?

The best dental plan for you and your family is the one with reasonable monthly premiums, affordable copayments or coinsurance, and a waiting period you can live with.

Discount plans serve as an alternative to traditional plans, and may be a better value too. If you do not require extensive service and only get routine checkups with the dentist, then you do not need as high of a coverage. These discount plans give you a card that gives you a percentage off of your services, but you are still responsible for the remaining amount.

You can save a lot of money with discount plans and regular insurance alike. Discount cards give you the opportunity to pay a lower cost for important dental services. Traditional policies can cover more services and more people, like your family.

Ultimately, dental insurance gives you the preventive care you and your family needs to avoid more extensive treatment. With a family policy with affordable individual and family deductibles, you are guaranteed the best oral health.

We can help you receive you ideal dentist plan. Find the dental plan that's best for you and your family today.

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