Dental Health Insurance EXPLAINED
Table of Contents
- Dental Health Insurance
- Affordability of Dental Insurance
- Dental Health Insurance Resources
Dental health insurance can be one of the more confusing types of insurance you deal with in the United States. Not everyone even considers dental insurance when seeking to protect their health. Dental is often thought to be simple cavity drilling and root canals. However, major dental problems can result in serious face and neck injury and affect a person's overall ability to live a normal life.
Needless to say, dental care is important to many people; and while it includes the basic cavity care, enamel cleaning, molar removal and tooth replacement, it can also include a lot of preventive care and complicated procedures that can save you from more serious medical problems.
Before getting started and discussing how dental insurance is available to you, it's important to focus on the various options out there and how you'll go about selecting it. Dental care falls under the overall health care category, so this means that dental plans are not offered nationwide. They're only offered state-by-state, and thus one state's plans and restrictions within may be different than another state's. You will have to be the one who puts in the research to find out which is best for you within your state.
As far as obtaining dental insurance goes, this part really isn't overly confusing. The confusion lies in knowing how it's presented in packages. Basically, you can receive dental coverage in two separate ways, through a group health insurance plan, or through an individual/private plan. For the individual plan, the dental insurance will be a supplement - and add-on. In a group package, this insurance should be included as a "dental" option in your overall health care.
Since a lot of dental procedures are considered to be "elective" procedures, most dental plans via group and private insurance companies are only going to cover anything they deem to be necessary. So while a root canal or a cap on a chipped tooth might be considered as usual dental work and will be covered, something like porcelain veneers might be considered a vanity or cosmetic procedure and won't be covered. You will have to read this within the individual plan, as most are different.
If you want better dental insurance than what most companies are providing, then it's important that you seek out additional coverage. You will have to contact the insurance agency or work out a new policy that covers the cost of some dental procedures beyond the usual cleanings, fillings and x-rays you'll receive.
Dental insurance works basically like regular health insurance, so there's no real mystery or confusion there. It's very similar to basic health insurance in that it's covered by HMO and PPO plans or payment structures. Occasionally, you may find an indemnity dental insurance plan, which allows for the ultimate freedom in choosing dentists and procedures, but these are becoming rare in this day and age.
Understanding a dental HMO and PPO is the same as understanding a regular health insurance structure. An HMO plan you pick will require you, as the patient, to choose either a single dentist or a dentist group to handle your dental care. After you select the dentist and/or facilities, all procedures deemed usual by the insurance company and performed per your plan will be covered. With a PPO plan, you will have the option of being able to select dentists from around your immediate area, so you're not locked in with only one option.
Any employer-based (group) health plan offering dental is probably going to be an HMO plan, and you'll have to use the specified doctor. However, there are exceptions to this, and some employers offer PPOs and allow you a little more freedom in the process. When selecting a private plan on your own, be sure to weigh the pros and cons of an HMO vs. a PPO.
Dental procedures are currently priced very high. This means that more and more insurance companies are providing less and less care through basic health insurance plans. Any plan you get on will emphasize preventive care, in order to cut back on costs associated with dental procedures. Obviously, there's no real way the insurance company can tell if you've been holding up your end of the bargain, but if the dentist suggests that you haven't been working to prevent certain problems, then the insurance company may refuse to pay and you could end up in a heated dispute.
Affordability of Dental Insurance
For what it covers, dental insurance can seem a little bit on the high side. However, when compared to regular health care packages, dental care is actually affordable. The most affordable plans are going to be available through an employer.
Private dental plans are going to cost a little bit more, but they will also provide more care, and you'll have a lot more freedom in choosing a policy that's right for you. Dental care is still basically viewed as a luxury in terms of what the companies will cover beyond the basics, and to that end, it can be hard to find a short term dental plan if you were thinking about looking for one.
Most short term health insurance plans will not offer other types of services like dental care. However, you can outright purchase dental care plans that are not part of an overall health package. To have both, you're looking at a lot more money per monthly premium, so this option isn't really worth entertaining unless you've lost your insurance completely and want to remain covered with dental until you can find a good replacement private or group plan.
Dental insurance can also be very fickle at times. There's not much separation in the procedures the insurance will cover and the procedures the company refuse to pay for. For example, a damaged tooth capped will be covered, but a covering for cosmetic reasons, relatively the same procedure, will not be covered unless specified.
Comparing quotes and finding the best options for you and your family is the only way to make sure you're getting the right type of dental coverage. You should never settle for bad coverage, and if you have the option, don't settle for basic coverage. Find a competing plan that provides ample coverage at a good price, and if you're getting into a group plan, purchase some supplemental care if the care offered isn't up to par.
Dental Health Insurance Resources
Publication 502, Medical and Dental Expenses
Dental insurance, either provided by your employer or a policy that you buy directly from a dental insurance company, is meant to help cover some of the costs associated with your dental care.
Proper dental care plays an important role in your overall good health. LANL employees participate in the Preferred PPO, which is administered by Delta Dental of California. This plan helps you save on out-of-pocket expenses for basic, prosthetic, and orthodontic services due to the reduced total fees charged by participating dentists.
Description: While NIDCR does not provide dental care or financial assistance for care, the Institute offers this fact sheet to help people find local, state, and federal sources of low-cost dental care.