Choosing Dental Coverage
Proper dental care can be an important component of our well being. As with all insurance-related decisions, there are multiple facets that should go into your decision when purchasing coverage for yourself or family. And, there several types of plans to consider such as managed care plans, dental indemnity insurance plans, and discount dental plans. Some Medicare Advantage (MA/MAPD) plans offer limited Dental coverage under their ancillary benefits, some offer cash reimbursement benefits. A good dental plan combined with a MA/MAPD reimbursement benefit "stretch" your dental budget.
Why it’s important
Dental coverage of some kind can help you ensure the health of your teeth and gums. Unfortunately, if you are bearing the full brunt of the cost of dental care you may find it difficult to pay your dentist bills. Without dental insurance coverage, you may be tempted to skip regular cleanings and checkups, a decision that could lead to serious dental health problems.
Types of Dental Insurance Coverage
Similar to medical insurance plans, dental insurance policies are often categorized as either indemnity or managed-care plans. The major differences are concentrated around out-of-pocket costs, choice of dental care providers, and how bills are paid.
Typically, indemnity coverage offers a broader selection of dental care providers than managed-care policies. With an indemnity policy, the carrier pays for covered services only after it receives a bill, which means that you may have to pay up front and then obtain reimbursement from your insurance carrier. Usually, managed-care policies maintain their own dental provider networks. Dentists participating in a network agree to perform services for patients at pre-negotiated rates and usually will submit the claim to the dental insurance company for you then bill any co-pay, co-insurance, deductible amounts remaining.
Basic Dental Insurance Coverage - What is Included?
Understanding what is covered by your dental insurance can be challenging. Coverage differs from policy to policy and from provider to provider. Read the fine print of your policy or agreement to find out what your dental insurance covers. In general, basic dental insurance coverage includes three categories:
- Preventive and diagnostic dental care: Almost all dental plans and dental insurance policies cover basic dental costs that are meant to prevent dental problems. For the policyholder that means, most plans cover a large part or all the dental costs associated with basic services such as cleaning, checkups, and other dental procedures meant to prevent tooth and gum disease. This coverage is important because it encourages people to seek regular dental care, which can prevent more complicated and costly problems. Popular plans cover 60-100% of these costs.
- Basic dental care and dental procedures: Most dental plans and dental insurance also cover basic dental procedures such as fillings, tooth extractions, fixing chipped teeth, and other such basic procedures. However, basic dental care varies from one provider to another. In general, since providers cover a significant portion of basic dental care, it makes sense to select a dental care insurance provider that covers as many dental care basics and procedures as possible. Popular plans may cover 25-80% of these costs.
- Major dental care: While not all dental insurance plans cover major dental care, some do cover at least a portion of these costs. Major dental care can include procedures such as dental surgery, orthodontics, denture work, and other large, expensive dental procedures. If you will require major dental care at some point in the future you may wish to look for a provider willing to pay for as large a percentage of this type of care as possible.
This is a brief overview of the coverage that can be included in a Dental Insurance policy. You should read a policy thoroughly before purchasing any insurance policy.