Getting Dental Insurance
Routine oral health care, including regular checkups and preventive services
, such as cleaning, is relatively inexpensive. Restorative dentil procedures, on the other hand, can be quite expensive.
These include procedures such as dental implants and crowns. Although many employers provide regular health insurance as a benefit, fewer also provide oral healthcare insurance.
As the cost of healthcare has increased, many employers have dropped dental coverage or shifted most of the monthly premium cost to their employees. For example, if you work for the federal government, you can get oral healthcare coverage at a relatively low cost but you will have to pay 100% of the premium.
Many people who do have oral health insurance, or are thinking about getting it, don't know what the plan covers. Although there are many ways that oral health coverage can be provided, the typical employer insurance plan uses a network of participating dentists.
They each provide a variety of features in their plan depending on where you live, and the number of people in your family that are insured. A typical plan includes a maximum benefit of $1000 to $1350 per year.
It also covers diagnostic and preventive care in which the insurance company pays 100 percent of costs. Most plans cover 80 percent of periodontal maintenance and cleanings.
They also pay 80 percent of the repair work on dentures. Coverage companies will probably also pay 50 percent of basic restorative work like fillings.
Some plans will pay for 50 percent of the cost of dentil surgery, like pulling a tooth. Most coverage companies also pay for 50 percent of the cost of getting a root canal.
After 12 months, the coverage plan may pay up to 50 percent of the cost of treating chronic gum disease, crowns, dentures, and temporomandibular joint dysfunction (TMJ) treatment. Cosmetic dental procedures, such as veneers or a smile makeover, are not typically covered by insurance.
The maximum benefit allowed each year and the percent that the plan pays your dentist for specific procedures will vary depending on the amount of premium you or your employer pay. The typical premium is about $50 per month.
If you can't get coverage from an employer, there are numerous oral healthcare plans available in most parts of the country that can be purchased by an individual. Most of these plans are some variation of a dental PPO in which you can access dental services from dentists that are part of the insurer's network or discount plans that pay some percent of your bill at a dentist of your choosing.
If you belong to an organization such as a local business group, college alumni association, fraternal organization, or religious group, check to see if they can provide access to a group oral healthcare coverage plan. If you are a member of AARP, you can purchase one of two dental plans from Delta Dental, one of the largest dental insurers in the U.S.
There are also online services that you can look into. There are many sites that offer information on different companies, rates, and what dentists accept certain insurance policies.
With any type of coverage that you get, you should check with the dentists, oral surgeons, or specialists in your area to make sure that they accept your coverage plan. If they don't and you receive service from them, you may have to pay the entire bill by yourself.
If you anticipate that your dental treatments will cost more than $500 per year, it might make sense for you to consider buying a policy or participating in a plan at work. If you and your family have healthy teeth and you are committed to oral health, you may not need coverage.
Remember, however, that once you need fillings, teeth that need to be pulled, or a root canal, the bills can add up very quickly. Except for accidental damage to a tooth, most diseases in the mouth can be prevented.
The best way to avoid the need for oral healthcare insurance and expensive dentist bills is to brush your teeth after every meal and floss regularly. You should also see your dentist every six months for a routine exam and cleaning.
by: Tom Selwick
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