Just like standard health insurance, dental insurance is something many Americans live without. In most cases it’s a perception of high cost which prevents people from purchasing dental insurance. But if you’re willing to compare dental insurance prices, you’re pretty likely to find that it doesn’t cost as much as you think it does.
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The cost of dental insurance is usually a fraction of what you pay for health insurance, yet the benefits of dental insurance are such that you really should get it if you can afford it. It can be used for routine dental exams, cleanings, fillings, and major oral surgery.
Why Dental Insurance is More than Just Cosmetic
If you’re a person who believes dental care is simply a matter of cosmetics, you’re not alone. Most people don’t realize how dangerous it is to practice poor dental hygiene. Certainly, cavities are a minor inconvenience when compared to other medical emergencies, but a cavity left untreated can lead to more serious issues that most people don’t anticipate. The reason for this lies in the construction of the dental system.
When you open your mouth and look at your teeth, what you see protruding above the gum line is merely the end of a complex system which includes enamel, dentin, pulp, cementum, the periodontal membrane, and the nerve. At the base of each tooth is a direct connection to the cardiovascular system. What this means is that an infected tooth has the potential to pass infection directly to the blood supply and on to the rest of the body.
Statistics show that people with significant tooth decay are far more likely to suffer from heart attacks, strokes, and other cardiovascular related emergencies. These serious conditions can be avoided through routine visits that address cavities as soon as they are detected. In the case of an impacted tooth, severe infection already exists at the site and should be dealt with immediately.
Different Kinds of Dental Insurance
Yes, there are as many different types of dental policies as there are providers. So when you compare dental insurance rates, it’s important to compare apples to apples so to speak.
Some policies are comprehensive while others are merely supplemental. Likewise, some policies will cover high-priced work while others will only cover dental work that has been deemed to be the least expensive of all options. In other words, you have to do your homework. Below is a brief synopsis of the basic categories of dental insurance.
- Preferred Provider Organization (PPO) Plan – A PPO dental plan uses a group of professionals who provide their services at a fixed lower cost. Many employers offer PPO plans due to their lower cost.
- Indemnity Plan – Dental insurance based on the indemnity plan is one where patients choose their own dentist and the specific treatments they desire. It is similar to standard health insurance and that there may be limits on what is covered, co-pays at the time of visit, and an annual cap on how much can be spent.
- Flexible Dental Account – Flexible spending accounts are offered by some employers to be used for medical and dental expenses. Sometimes these flexible spending accounts are offered in conjunction with a self-insured dental plan. These plans allow patients to spend dental and health care dollars as they see fit.
- Reimbursement Plan – A reimbursement plan operates just as its name suggests. Patients choose dental work to be done and submit bills to the insurance company for reimbursement. Most of these plans have reimbursement limits which vary from provider to provider.
Know What Dental Insurance Covers
What dental insurance does and doesn’t cover is tricky because of the nature of this coverage. As suggested earlier, at the time you compare dental insurance policies, make sure you are familiar with what your chosen policy covers. Take a look at some of the issues:
- Under many dental plans, even things as simple as fillings can be debated when the bill comes due. A particular insurance company may refuse to pay the cost of a composite of filling, insisting instead that they will pay only an amount equal to a less expensive traditional filling.
- Another area of contention is with crowns and cosmetic dental procedures. Should you need a root canal for example, your insurance policy may cover most of the procedure with the exception of a crown. If a crown is not absolutely necessary, it may have been deemed a cosmetic addition by your insurance provider. In this case you could be faced with a bill of $1,000 or more.
- It’s almost universally accepted by the dental insurance industry that cosmetic procedures will not be covered. However, supplemental dental insurance does exist to cover such expenses. As you compare dental insurance rates you may want to think about supplemental insurance if you plan to have cosmetic work done.
Regardless of the dental policy you choose, plan on paying some portion of individual bills yourself. More and more, insurance companies are requiring co-pays or a certain percentage of the bill to be picked up by the customer. This is to encourage financial discipline when spending health insurance money. In some way, shape, or form there will be some out-of-pocket expense for your dental worked.
How to Keep Out-of-Pocket Expenses as Manageable as Possible?
As the cost of dental work continues to rise, so do out-of-pockets expenses. Managing these expenses is similar to managing the normal household expenses you incur every day. You may look for sales or coupons for your weekly shopping, or you may visit more than one store to get the best price.
Shopping for a discount dental plans is a similar way to help manage your out of pocket expenses. A discount dental plan is one where a network of participating dental professionals agrees to provide services at discounted rates to members who will pay in full at the time of service.
As previously mentioned, your employer may also offer flexible spending accounts that can be used for out-of-pocket dental expenses. The employee contributes a specified amount of pre-tax dollars to the account that can be applied to dental expenses. Keep in mind however, that flexible spending accounts do have annual limits.
Finally, check with your dentist to see if he offers in-house financing or payment plans. Many dentists are willing to extend such payment options to patients with whom they have established a long-term relationship.
One thing that works in your favor here is the fact that insurance companies rarely reimburse at the rate the dental provider normally charges. If you have a good relationship with your dentist, he may be willing to extend a payment plan in order to receive his full rate.
In conclusion, dental insurance is a complex matter that is sometimes difficult to understand. As you compare dental insurance policies, direct your questions to the insurance company providing the policy. Their trained customer service staff should be able to answer most of your questions.
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