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Understanding Dental Insurance

Having dental insurance can provide you with much needed peace of  mind, especially considering the high cost of dental work. 

Dental plans offer coverage for anything from routine exams and cleanings to more complex procedures such as root canals and extractions, some dental plans may cover dentures and crowns.

What's Typically Covered?

Typically, a dental insurance policy will cover regular checkups and  cleanings twice a year, although there may or may not be an out-of-pocket copay required for each appointment. 

Most dental insurance  plans will also cover the majority or all of the expenses related to cavity fillings.

In addition to check-ups and fillings, dental insurance should cover annual X-rays, crowns, root canals, and other necessary repair work.  However, it is possible that policy holders will be responsible for  paying a deductible before coverage will kick in for these types of  procedures.

What's Typically Not Covered?

While most dental plans cover basic dental work and preventative  procedures, there are some procedures that many do not provide coverage for. A prime example of this is composite (tooth-colored) fillings.  Often, coverage will only be provided for amalgam (silver) fillings,  and policy holders will be responsible for paying the difference if they  prefer composite fillings.

Cosmetic procedures, such as tooth-whitening treatments, are also usually not covered by insurance. Other non-covered treatments may  include:

  • orthodontic treatments (braces)
  • dental implants
  • dental care related to a medical condition

Are Their Networks With Dental Plans?

Dental insurance comes in three varieties: HMO, PPO and indemnity plans.

  • The HMO, or health maintenance organization, option restricts coverage to dental professionals within a limited network.
  • More popular are the PPO, or preferred provider organization,  policies, which are similar to HMOs but allow patients to see dentists  outside the “preferred” network. However, patients are typically charged  reduced rates if they see an in-network dentist. Some 70 percent of  dental policies are through PPOs, according to Ireland.
  • A third option, called an indemnity plan, allows a patient to see any dentist and typically picks up a percentage of the costs.

The advantage of PPOs over indemnity plans is that dentists within  the PPO network typically agree to accept lower fees for procedures. So, a crown that results in $500 in patient costs under an indemnity plan  might mean $400 in out-of-pocket costs under a PPO plan.

How Much Does a Dental Plan Cost?

The monthly premium wil vary depending on the face value of the plan ($1,000, $1,500, $2,500 per year). Cost is determined by the insureds age at the time the policy issues and can range from as low as $25 a month to as high as $75 per month. It's recommended you speak with a broker from our agency to customize a plan that best meets your needs and budget.

Call today for a free quote!