Dental Insurance Features You Need to Look For
Insurance is protection against risk. Dental insurance would help cover expenses that you may have to incur for undergoing dental treatments. Generally, dental insurance premiums are less expensive than those of general health insurance. However, there are limitations to dental insurance.
An annual limit of around $1500 would be fixed by most insurers. Most dental expenses like X-rays, exams would be reimbursed up to 80% of the costs. But for expensive treatments like root canals and crowns, you may get only 50% of the costs incurred. Cosmetic dentistry will not be covered by most insurers.
Dental Insurance Plans
A majority of American get their dental insurance from employers. Group insurance policies provided by employers would cover more and would cost lesser. Insurance marketplaces also allow you to get dental insurance from different providers. Following are the types of dental plans that one can avail.
1) HMO (Health Maintenance Organization): This is a less expensive option and allows you to get dental care with expenses reimbursed from the network of dental care providers. If you do not get treated from a dentist in the network, you may have to shell out the costs yourself.
2) PPO (Preferred Provider Organization): PPO plans are more expensive than HMO plans. They also have a network of dentists from whom treatment can be availed. Here, even if you avail treatment from someone not in the network, you can get some of your expenses reimbursed.
3) Dental indemnity plans: These plans have a higher premium. A co-pay fee is set that you would pay for a dental visit. The advantage of these plans is that you can go with any dentist you want.
4) Dental discount plans: These plans are strictly not insurance. They involve paying a monthly fee (around $10 to $15) to the provider. In return, you would get a discount on the dental expenses incurred.
Services offered by dental plans
Dental plans offer services that are grouped under four classes. They are:
1) Class I: That covers diagnostic and preventive dental care. This includes annual checkups, X-rays and cleaning.
2) Class II: This includes restoration procedures like fillings and root canals.
3) Class III: This covers major restorations required like crowns and bridges.
4) Class IV: This involves braces, however only some providers offer this plan. It is usually offered only for those who are below 19 years of age.
In PPO type of plans, the coverage offers 100% of expenses for Class I services, 80% expenses for Class II services and 50% expenses for Class III.
In HMP type of plans, there is a co-payment option. Instead of a percent of the fee, they charge a flat fee like $10 for Class I and $15 for Class II. This varies from provider to provider.
Selecting the right dental insurance plan
To select the dental insurance plan that is best suited, you need to shop around. Compare services offered by different providers and the premiums or co-plan expenses. After making a proper comparison, you can take a decision on which insurer to choose. If you are looking for fixed costs, then you can choose HMO plans. If you are ready to pay more to get a larger pool of dentists to choose from, then you choose PPO plans.
If you want the freedom to choose any dentist of your choice, then you can consider opting for a dental indemnity plan. Your first choice should be to find out if your employer could provide dental insurance as this would be cheaper. If this option is not available, you can go for individual plans.
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